Organization
NEW MERCY BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTE CLARK (CREDENTIALING MANAGER)
(770) 339-7667
Entity
Organization
Contact information
Practice address
135 BOUNDS ST, JACKSON, MS 39206-4121
(601) 808-1820
Mailing address
PO BOX 1491, AUGUSTA, GA 30903-1491
(601) 808-1820
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
05/06/2021
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