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Organization

BRENTWOOD ACQUISITION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVE FILTON (SR VP CFO)
(610) 768-3300
Entity
Organization

Contact information

Practice address
3531 LAKELAND DR, FLOWOOD, MS 39232-8016
(601) 936-2024
(601) 936-7818
Mailing address
3531 LAKELAND DR, FLOWOOD, MS 39232-8016
(601) 936-2024
(601) 936-7818

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
32-330
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000020855
BLUE CROSS PROVIDER NUMBE
MS
05
00220625
MS
Enumeration date
12/02/2005
Last updated
02/23/2011
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