Organization
REGION IV MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI LYNN WATSON RN (NURSE)
(662) 563-9176
Entity
Organization
Contact information
Practice address
120 RANDY HENDRIX DR, BATESVILLE, MS 38606-7664
(662) 563-9176
Mailing address
120 RANDY HENDRIX DR, BATESVILLE, MS 38606-7664
(662) 563-9176
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
R745718
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699869537
—
MS
Enumeration date
10/08/2013
Last updated
10/08/2013
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