Organization
CHASE HOUSE OF YOUTH RESTORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASON TODD HESTER (DIRECTOR)
(662) 586-8081
Entity
Organization
Contact information
Practice address
394 W OXFORD ST, PONTOTOC, MS 38863-1219
(662) 586-8081
Mailing address
394 W OXFORD ST, PONTOTOC, MS 38863-1219
(662) 586-8081
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/26/2024
Last updated
11/14/2024
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