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Organization

MISSISSIPPI STATE HOSPITAL

Active
Other names
Lighthouse Medical Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES G. CHASTAIN (DIRECTOR OF HOSPITAL)
(601) 351-8000
Entity
Organization

Contact information

Practice address
350 CAPERS AVE, JACKSON, MS 39203-2131
(601) 351-8000
Mailing address
350 CAPERS AVE, JACKSON, MS 39203-2131

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
DCS-MSH
MS

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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