# BRAIN GROUP

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

## Provider details

- **NPI number:** 1790476737
- **Authorized official:** DR. MARK J MCNEIL LCSW (CFO)
- **Authorized official phone:** (601) 324-3109

## Contact information

- **Practice address:** 608 DELAWARE AVENUE, MCCOMB, MISSISSIPPI, UNITED STATES, MCCOMB, MS 39648
- **Practice address phone:** (601) 324-3109
- **Practice address fax:** (601) 324-3105
- **Mailing address:** 608 DELAWARE AVE, MCCOMB, MS 39648-4025
- **Mailing address phone:** (601) 324-3109
- **Mailing address fax:** (601) 324-3105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/19/2023
- **Last updated:** 11/15/2023