Organization
SINGING RIVER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERMAN F BLACKWELL (EXECUTIVE DIRECTOR)
(228) 497-0690
Entity
Organization
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-7604
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-7604
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
05
—
00770256
—
MS
Enumeration date
02/19/2015
Last updated
02/19/2015
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