Organization
POSITIVE GROWTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE LEONARD (DIRECTOR)
(601) 873-8052
Entity
Organization
Contact information
Practice address
4780 I 55 N, JACKSON, MS 39211-5542
(601) 873-8052
Mailing address
4780 I 55 N, JACKSON, MS 39211-5542
(601) 873-8052
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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