Organization
GULF COAST MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY J MCDONALD (BILLING SUPERVISOR)
(228) 863-1132
Entity
Organization
Contact information
Practice address
15094 COUNTY BARN ROAD, GULFPORT, MS 39503
(228) 863-0091
(228) 864-2241
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
M8723
MS
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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