Organization
SOUTHERN COMMUNITIES BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN REEVES (OWNER)
(630) 379-6755
Entity
Organization
Contact information
Practice address
402 GREENWOOD ST, PORT GIBSON, MS 39150-2626
(601) 448-5171
Mailing address
PO BOX 78, PORT GIBSON, MS 39150-0078
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2212
MS
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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