Organization
REGION IV CHEMICAL DEPENDENCY COMPLEX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLIE D SPEARMAN SR. (EXECUITIVE DIRECTOR)
(662) 286-9883
Entity
Organization
Contact information
Practice address
401 NEW HOPE DR, CORINTH, MS 38834-7458
(662) 287-7199
(662) 286-8908
Mailing address
PO BOX 839, CORINTH, MS 38835-0839
(662) 286-9883
(662) 286-9836
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018204
—
MS
Enumeration date
10/24/2011
Last updated
10/24/2011
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