Organization
VINER COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL SHANE VINER L.P.C. (CEO)
(662) 226-3762
Entity
Organization
Contact information
Practice address
501 SOUTHWEST FRONTAGE RD, GRENADA, MS 38901
(662) 226-3762
Mailing address
PO BOX 1251, GRENADA, MS 38902-1251
(662) 226-3762
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0563
MS
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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