Organization
MODERN HOPE OF MS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KING (CEO)
(336) 745-1499
Entity
Organization
Contact information
Practice address
16 NORTHTOWN DR STE 106, JACKSON, MS 39211-3058
(336) 745-1499
Mailing address
755 HIGHLAND OAKS DR STE 204, WINSTON SALEM, NC 27103-7106
(336) 745-1499
(434) 549-5788
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/05/2020
Last updated
11/15/2023
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