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SOUTH MISSISSIPPI REGIONAL CENTER

Intermediate Care Facility, Mentally Retarded

Long Beach, Mississippi

Provider NPI: 1033143284

Organization Information:
Organization Name:  SOUTH MISSISSIPPI REGIONAL CENTER


Practice Location:
1170 W RAILROAD ST  LONG BEACH, MS 39560 US
Tel: 228-867-1300  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
MS311

Other Provider Identifiers:

IssuerNumberStateType
00095206MS05
09015481MS05
09555710MS05
00021842MS05
00770072MS05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS MS - Page 1



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