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Organization
HEALTHCARE ADVANTAGE LLC
Active
Organization
HEALTHCARE ADVANTAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD INGRAM MANAGER (MANAGER)
(601) 420-0141
Entity
Organization
Contact information
Practice address
254 INGLESIDE DR, MADISON, MS 39110-9524
(601) 695-1919
(601) 420-5299
Mailing address
PO BOX 1995, MADISON, MS 39130-1995
(601) 695-1919
(601) 420-5299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000000
TO BE ASSIGNED
—
Enumeration date
10/06/2009
Last updated
03/16/2010
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