Organization
DELTA HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEYMOUR MITCHELL (CEO)
(662) 741-2151
Entity
Organization
Contact information
Practice address
702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 38762-9314
(662) 741-2151
(662) 741-2339
Mailing address
702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 38762-9314
(662) 741-2151
(662) 741-2339
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
11562
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04404037
—
MS
Enumeration date
07/28/2006
Last updated
08/22/2020
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