Organization
MIDDLE MS ACCESS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY MICHAEL GRAY PH.D (CHIEF FINANCIAL OFFICER)
(601) 940-0183
Entity
Organization
Contact information
Practice address
620 W AMITE ST, JACKSON, MS 39203-2618
(601) 940-0183
Mailing address
PO BOX 757, TERRY, MS 39170-0757
(601) 940-0183
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000
MS
Other
Enumeration date
01/24/2014
Last updated
01/30/2014
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