Organization
EAST MISSISSIPPI STATE HOSPITAL
Active
Parent organization
BRADLEY A. SANDERS ADOLESCENT COMPLEX
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRADLEY A. SANDERS ADOLESCENT COMPLEX
Authorized official
MR. WILLIAM HAMRICK ENTREKIN (BUSINESS SERVICES DIRECTOR)
(601) 581-7969
Entity
Organization
Contact information
Practice address
1401 COLLEGE DR, MERIDIAN, MS 39307-5345
(601) 587-7562
(601) 581-7707
Mailing address
PO BOX 4128, MERIDIAN, MS 39304-4128
(601) 581-7562
(601) 581-7707
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
31-136
MS
Other
Enumeration date
06/04/2014
Last updated
05/05/2020
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