Organization
FRONTLINE RECOVERY, LLC
Active
Other names
Jolimar Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF RAYBORN (PRESIDENT)
(601) 276-9556
Entity
Organization
Contact information
Practice address
1038 RIVER RIDGE RD, SUMMIT, MS 39666-9715
(601) 276-9556
(601) 276-9578
Mailing address
PO BOX 1176, SUMMIT, MS 39666-1176
(601) 276-9556
(601) 276-9578
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
FS36BAEAPR/TR-OP-O1
MS
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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