Organization
SINGING RIVER SERVICES
Active
Other names
Singing River Mental Health Mental Retardation Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERMAN F BLACKWELL II PHD (EXECUTIVE DIRECTOR)
(228) 497-0690
Entity
Organization
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553
(228) 497-0690
(228) 497-1363
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553
(228) 497-0690
(228) 497-1363
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
05
—
00770256
—
MS
Enumeration date
08/22/2006
Last updated
05/10/2010
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