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Organization

MISSISSIPPI CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MYLEME O HARRISON MD (CEO)
(919) 423-0267
Entity
Organization

Contact information

Practice address
100 W AMITE ST, JACKSON, MS 39201-1203
(919) 423-0267
Mailing address
6026 SIX FORKS RD, RALEIGH, NC 27609-3899
(919) 423-0267

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261Q00000X
Clinic/Center
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM1300X
Multi-Specialty Clinic/Center
261QP2300X
Primary Care Clinic/Center

Other

Enumeration date
01/25/2018
Last updated
01/25/2018
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