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Organization

UTILIZATION MANAGEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHERRY ROBERTS RN,CCM,CPUR,CNLCP (DIRECTOR, MANAGED CARE)
(601) 605-2023
Entity
Organization

Contact information

Practice address
576 HIGHLAND COLONY PKWY, SUITE 300, RIDGELAND, MS 39157-8769
(601) 605-2023
Mailing address
PO BOX 1859, RIDGELAND, MS 39158-1859
(601) 605-2023

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
9923719
MS

Other

Enumeration date
12/19/2007
Last updated
12/19/2007
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