Organization
REGION XII COMM ON MENTAL HEALTH DBA PINE BELT MENTAL HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET MAYS (CFO)
(601) 544-4641
Entity
Organization
Contact information
Practice address
103 S 19TH AVE, HATTIESBURG, MS 39401-6171
(601) 544-4641
(601) 584-4053
Mailing address
PO BOX 1030, HATTIESBURG, MS 39403-1030
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770355
—
MS
Enumeration date
04/03/2008
Last updated
04/03/2008
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