Organization
TRINITY BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLANDRIA HUDSON LCSW (OWNER/CEO)
(601) 942-1129
Entity
Organization
Contact information
Practice address
1618 PEAR ORCHARD PL, JACKSON, MS 39211-2206
(601) 942-1129
Mailing address
1618 PEAR ORCHARD PL, JACKSON, MS 39211-2206
(601) 942-1129
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
C-5832
MS
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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