Organization
EASTER SEALS MISSISSIPPI INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL KHOURY (CFO)
(662) 432-2995
Entity
Organization
Contact information
Practice address
2901 S EASON BLVD, TUPELO, MS 38804-5945
(682) 432-2995
(817) 303-9274
Mailing address
2901 S EASON BLVD, TUPELO, MS 38804-5945
(682) 432-2995
(817) 303-9274
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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