Organization
METHODIST CHILDREN'S HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEVON LOGGINS LCSW (VICE PRESIDENT OF PROGRAMS)
(601) 853-5000
Entity
Organization
Contact information
Practice address
805 N FLAG CHAPEL RD, JACKSON, MS 39209-2208
(601) 853-5000
Mailing address
805 N FLAG CHAPEL RD, JACKSON, MS 39209-2208
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03078895
—
MS
Enumeration date
03/29/2014
Last updated
03/29/2014
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