Organization
PSYCAMORE, LLC
Active
Organization
PSYCAMORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE A HALL CMM (DIRECTOR, BUSINESS OPERATIONS)
(601) 939-5993
Entity
Organization
Contact information
Practice address
2620 EXECUTIVE PL, BILOXI, MS 39531-3717
(228) 385-7744
(601) 939-5935
Mailing address
2620 EXECUTIVE PL, BILOXI, MS 39531-3717
(601) 939-5993
(601) 939-5935
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
DCS-PSYCAMORE-PHA-01
MS
261QM0855X
Adolescent and Children Mental Health Clinic/Center
DCS-PSYCAMORE-PHA-01
MS
Other
Enumeration date
08/10/2011
Last updated
12/22/2016
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