Organization
REHABILITATION CENTERS, INC., D/B/A MILLCREEK OF PONTOTOC
Active
Other names
Millcreek of Pontotoc MYPAC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED HOOD (CHIEF EXECUTIVE OFFICER)
(662) 488-8878
Entity
Organization
Contact information
Practice address
1814 HIGHWAY 15 N, PONTOTOC, MS 38863-6962
(662) 488-8878
(662) 488-8767
Mailing address
1814 HIGHWAY 15 N, PONTOTOC, MS 38863-6962
(662) 488-8878
(662) 488-8767
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
911
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220588
—
MS
Enumeration date
04/20/2015
Last updated
04/20/2015
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