Organization
SOUTHWEST MISSISSIPPI MENTAL HEALTH MENTAL RETARDATION COMMISSION
Active
Parent organization
SOUTHWEST MISSISSIPPI MENTAL HEALTH MENTAL RETARDATION COMMISSION
Other names
SW MS MENTAL HEALTH REGION XI
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST MISSISSIPPI MENTAL HEALTH MENTAL RETARDATION COMMISSION
Authorized official
JAMES STEVEN ELLIS PHD (EXECUTIVE DIRECTOR)
(601) 684-2173
Entity
Organization
Contact information
Practice address
1701 WHITE ST, MCCOMB, MS 39648-2711
(601) 684-2173
(601) 249-4234
Mailing address
PO BOX 768, MCCOMB, MS 39649-0768
(601) 684-2173
(601) 249-4234
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018211
—
MS
Enumeration date
10/16/2008
Last updated
06/16/2009
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