Organization
WARREN YAZOO MENTAL HEALTH SERVICE
Active
Other names
Warren Yazoo Mental Health Service, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
RICK VESSELL CPA (CHIEF FINANCIAL OFFICER)
(601) 638-0031
Entity
Organization
Contact information
Practice address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 638-0031
(601) 634-0234
Mailing address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 638-0031
(601) 634-0234
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
R15-1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018215
—
MS
05
—
00770336
—
MS
Enumeration date
09/07/2005
Last updated
02/06/2017
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