Organization
SAINT JOSHUAS THERAPEUTIC GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA T SMITH (PRESIDENT)
(601) 316-4822
Entity
Organization
Contact information
Practice address
3409 N STATE ST, JACKSON, MS 39216-3136
(769) 257-5466
(866) 224-2940
Mailing address
4078 PINE HILL DR, JACKSON, MS 39206-5738
(769) 257-5466
(866) 224-2940
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
06071213
MS
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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