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Organization

BEACON BEHAVIORAL OF MISSISSIPPI, LLC

Active
Parent organization
BEACON BEHAVIORAL OF MISSISSIPPI, LLC
Other names
Right Track Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
BEACON BEHAVIORAL OF MISSISSIPPI, LLC
Authorized official
KIMBERLY GLAVESKAS (CREDENTIALING SUPERVISOR)
(443) 962-3945
Entity
Organization

Contact information

Practice address
9035 E SANDIDGE RD STE 201, OLIVE BRANCH, MS 38654-3563
(662) 408-4631
Mailing address
PO BOX 306603, NASHVILLE, TN 37230-6603
(662) 234-7601

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
07/11/2024
Last updated
07/11/2024
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