Organization
NORTHEAST MISSISSIPPI PLANNING AND DEVELOPMENT DISTRICT
Active
Other names
Elderly and Disabled Medicaid Waiver Program
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON GARDNER (EXECUTIVE DIRECTOR)
(662) 728-7038
Entity
Organization
Contact information
Practice address
619 E. PARKER, BOONEVILLE, MS 38829
(662) 728-7038
(662) 728-2417
Mailing address
P.O.BOX 600, BOONEVILLE, MS 38829
(662) 728-7038
(662) 728-2417
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00770312
PROVIDER NUMBER
MS
Enumeration date
10/03/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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