Organization
EXTRA MILE RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT SMITH (OWNER/OPERATOR)
(901) 626-4454
Entity
Organization
Contact information
Practice address
720 OAK GROVE RD, MANTACHIE, MS 38855
(662) 246-2946
Mailing address
720 OAK GROVE RD, MANTACHIE, MS 38855
(662) 246-2946
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
01/07/2025
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