Organization
360INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAI DEREK DOWELL (SITE DIRECTOR)
(901) 275-1452
Entity
Organization
Contact information
Practice address
8547 HIGHWAY 178, BYHALIA, MS 38611-9670
(901) 275-1452
Mailing address
27 DUDLEY CV, BYHALIA, MS 38611-6884
(662) 838-2142
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/18/2020
Last updated
10/18/2020
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