# SOUTHERN HEALTH CORP. OF HOUSTON, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Trace Regional Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003096488
- **Authorized official:** MS. SHEILA BROCKMAN (CEO)
- **Authorized official phone:** (662) 456-3700

## Contact information

- **Practice address:** 1002 E MADISON ST, HOUSTON, MS 38851-2417
- **Practice address phone:** (662) 456-1163
- **Practice address fax:** (662) 456-1159
- **Mailing address:** PO BOX 626, HOUSTON, MS 38851-0626
- **Mailing address phone:** (662) 456-1163
- **Mailing address fax:** (662) 456-1159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 12-296 | MS | Yes |

## Other

- **Enumeration date:** 11/14/2007
- **Last updated:** 01/18/2024