MEDICARE: CH MH SERVICES (MS), LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1558134288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CH MH SERVICES (MS), LLC

Provider Business Mailing Address
First Line	:	169 MADISON AVE STE 15011
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-5101
Country	:	US
Telephone Number	:	986-206-0414
Fax Number	:	406-794-0395

Provider Business Practice Location Address
First Line	:	1755 LELIA DR STE 304
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-4828
Country	:	US
Telephone Number	:	406-219-7835
Fax Number	:	406-794-0395

Authorized Official
Title or Position	:	VP, RCM
Name	:	CHARIE BRYANT
Credential	:
Telephone Number	:	803-955-6655

Provider Enumeration Date	:	11/03/2023
Last Update Date	:	11/14/2025

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Directions to “CH MH SERVICES (MS), LLC ” Practice Location

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