Organization
THE HILLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY BLALOCK HENRY PH.D. (OWNER/DIRECTOR)
(601) 310-1057
Entity
Organization
Contact information
Practice address
2018 HARDY ST, SUITE 20, HATTIESBURG, MS 39401-4975
(601) 336-0445
Mailing address
2018 HARDY ST, SUITE 20, HATTIESBURG, MS 39401-4975
(601) 336-0445
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1099
KS
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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