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Organization
MISSISSIPPI STATE HOSPITAL
Active
Organization
MISSISSIPPI STATE HOSPITAL
Active
Other names
Lighthouse Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES G. CHASTAIN (DIRECTOR OF HOSPITAL)
(601) 351-8000
Entity
Organization
Contact information
Practice address
350 CAPERS AVE, JACKSON, MS 39203-2131
(601) 351-8000
Mailing address
350 CAPERS AVE, JACKSON, MS 39203-2131
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
DCS-MSH
MS
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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