# MID SOUTH REHAB OUTPATIENT, LLC

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

## Provider details

- **NPI number:** 1447580915
- **Authorized official:** STEVEN COLE (CEO)
- **Authorized official phone:** (601) 605-6777

## Contact information

- **Practice address:** 6100 KITT LN NW, HUNTSVILLE, AL 35806-3068
- **Practice address phone:** (601) 605-6777
- **Practice address fax:** (800) 517-6935
- **Mailing address:** 599C STEED RD, RIDGELAND, MS 39157-1707
- **Mailing address phone:** (601) 605-6777
- **Mailing address fax:** (800) 517-6935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/06/2010
- **Last updated:** 04/20/2022