Organization
FAMILY FOCUS
Active
Other names
Ellen L Malone Sole MBR
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN L MALONE LISW, LCSW, ACSW (OWER/SOLE MBR)
(228) 497-8180
Entity
Organization
Contact information
Practice address
1408 HIGHWAY 90, SUITE 2, GAUTIER, MS 39553-5456
(228) 497-8180
(228) 497-6594
Mailing address
PO BOX 1512, GAUTIER, MS 39553-0019
(228) 497-8180
(228) 497-6594
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C2571
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07933592
—
MS
Enumeration date
01/12/2009
Last updated
08/29/2011
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