Organization
MEMORIAL HOSPITAL @ GULFPORT
Active
Other names
Memorial Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE E JOHNSON (OFFICE MANAGER)
(228) 575-1970
Entity
Organization
Contact information
Practice address
11150 HIGHWAY 49, GULFPORT, MS 39503-4110
(228) 575-1000
(228) 575-2002
Mailing address
11150 HIGHWAY 49, GULFPORT, MS 39503-4110
(228) 575-1000
(228) 575-2002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C6816
MS
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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