Organization
ANCOR CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERTRAND ANTOINE (PRESIDENT)
(662) 627-5317
Entity
Organization
Contact information
Practice address
500 DESOTO AVE, CLARKSDALE, MS 38614-5217
(662) 627-5317
Mailing address
500 DESOTO AVE, CLARKSDALE, MS 38614-5217
(662) 627-5317
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
07427785
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07427785
—
MS
Enumeration date
01/22/2010
Last updated
01/22/2010
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