Organization
GULF COAST MENTAL HEALTH CENTER
Active
Other names
GULF COAST MENTAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E JONES CPA (CFO)
(228) 863-1132
Entity
Organization
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
REG13-SO-01
MS
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
R-13-1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018213
—
MS
01
—
C00120
CENTER MEDICARE ID
MS
01
—
QMP000005325798
MOLINA MEDICAID
MS
Enumeration date
12/23/2005
Last updated
09/21/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us