# REHABILITATION CENTERS, INC., D/B/A MILLCREEK OF PONTOTOC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Millcreek of Pontotoc MYPAC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538556311
- **Authorized official:** MR. ED HOOD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (662) 488-8878

## Contact information

- **Practice address:** 1814 HIGHWAY 15 N, PONTOTOC, MS 38863-6962
- **Practice address phone:** (662) 488-8878
- **Practice address fax:** (662) 488-8767
- **Mailing address:** 1814 HIGHWAY 15 N, PONTOTOC, MS 38863-6962
- **Mailing address phone:** (662) 488-8878
- **Mailing address fax:** (662) 488-8767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 911 | MS | Yes |

## Other

- **Enumeration date:** 04/20/2015
- **Last updated:** 04/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00220588 | — | MS |