# A FOCUSED BRAIN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184080426
- **Authorized official:** JOHN POE (OFFICE MANAGER)
- **Authorized official phone:** (601) 427-5775

## Contact information

- **Practice address:** 7712 OLD CANTON RD, MADISON, MS 39110-9299
- **Practice address phone:** (601) 427-5775
- **Mailing address:** 4345 MEADOWRIDGE DR, JACKSON, MS 39206-5912
- **Mailing address phone:** (601) 259-6917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | OT2806 | MS | Yes |

## Other

- **Enumeration date:** 12/31/2015
- **Last updated:** 12/31/2015
