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Organization

MISSISSIPPI STATE HOSPITAL AT WHITFIELD

Active
Parent organization
MISSISSIPPI STATE HOSPITAL AT WHITFIELD
Other names
Mississippi State Hospital Community Services Mental Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
MISSISSIPPI STATE HOSPITAL AT WHITFIELD
Authorized official
MR. JAMES G CHASTAIN (DIRECTOR)
(601) 351-8000
Entity
Organization

Contact information

Practice address
350 CAPERS AVENUE, JACKSON, MS 39203
(601) 351-8000
(601) 351-8301
Mailing address
P.O. BOX 1 - FISCAL SERVICES, 3550 HIGHWAY 468 WEST, WHITFIELD, MS 39193-0157
(601) 351-8000
(601) 351-8301

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
DCS-MSH
MS
320800000X
Mental Illness Community Based Residential Treatment Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04972797
MS
Enumeration date
10/26/2006
Last updated
03/14/2012
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