Organization
GARDEN PARK
Active
Other names
Region VI Mental Health/Mental Retardation Commission
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MADOLYN SMITH (EXECUTIVE DIRECTOR)
(662) 453-6211
Entity
Organization
Contact information
Practice address
2504 BROWNING ROAD, GREENWOOD, MS 38935-1505
(662) 453-6211
(662) 455-8724
Mailing address
PO BOX 1505, GREENWOOD, MS 38935-1505
(662) 453-6211
(662) 455-8724
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770409
—
MS
Enumeration date
11/25/2009
Last updated
11/25/2009
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