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Organization
GULF COAST MENTAL HEALTH CENTER
Active
Organization
GULF COAST MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY JO MCDONALD (BILLING SUPERVISOR)
(228) 863-1132
Entity
Organization
Contact information
Practice address
1600 BROAD AVENUE, GULFPORT, MS 39501
(228) 863-1132
(228) 865-1700
Mailing address
1600 BROAD AVENUE, GULFPORT, MS 39501
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
M8456
NULL
2251S0007X
Sports Physical Therapist
Primary
M8456
—
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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