Organization
BOSWELL REGIONAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND JOHNSON (DIRECTOR)
(601) 867-5000
Entity
Organization
Contact information
Practice address
1049 SIMPSON HIGHWAY 149 SOUTH, MAGEE, MS 39111-0128
(601) 867-5000
(601) 849-2586
Mailing address
PO BOX 128, MAGEE, MS 39111-0128
(601) 867-5000
(601) 849-2586
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
341
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00021838
—
MS
Enumeration date
07/20/2006
Last updated
08/22/2020
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