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Organization
NORTHEAST MENTAL HEALTH/MENTAL RETARDATION COMMISSION
Active
Organization
NORTHEAST MENTAL HEALTH/MENTAL RETARDATION COMMISSION
Active
Other names
Northeast Mental Health-Menta
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAQUEL ROSAMOND (EXECUTIVE DIRECTOR)
(662) 640-4595
Entity
Organization
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4695
(662) 680-6416
Mailing address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
(662) 680-6416
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018203
—
MS
Enumeration date
07/06/2006
Last updated
10/28/2020
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