Organization
EAST MISSISSIPPI STATE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES A. CARLISLE MPPA (FACILITY DIRECTOR)
(601) 581-7878
Entity
Organization
Contact information
Practice address
4555 HIGHLAND PARK DRIVE, MERIDIAN, MS 39307
(601) 581-7600
Mailing address
P.O. BOX 4128, WEST STATION, MERIDIAN, MS 39304-4128
(601) 581-7600
(601) 581-7676
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
31-136
MS
Other
Enumeration date
08/03/2010
Last updated
10/14/2020
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