Organization
SOUTHWEST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WIRT L PETERSON (EXECUTIVE DIRECTOR)
(601) 446-6044
Entity
Organization
Contact information
Practice address
2265 HIGHWAY 84 E, MEADVILLE, MS 39653-8447
(601) 384-5200
(601) 384-5315
Mailing address
100 S WALL ST, NATCHEZ, MS 39120-3477
(601) 446-6044
(601) 446-6071
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770117
—
MS
05
—
00770314
—
MS
05
—
06026374
—
MS
01
—
1467556092
NPI
MS
01
—
1811169840
NPI
MS
01
—
1861591075
NPI
MS
Enumeration date
12/05/2011
Last updated
12/05/2011
Update your record
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