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
819B CENTRAL AVE, BAY ST LOUIS, MS 39520-3913
(228) 467-1881
(228) 865-1700
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
M9097
MS
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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