Organization
JACKSON VAMC
Active
Other names
JACKSON VA CARE SITE
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
1500 WOODROW WILSON AVE, JACKSON, MS 39216-5116
(615) 355-3451
Mailing address
PO BOX 94497, CLEVELAND, OH 44101-4497
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/30/2016
Last updated
10/04/2017
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