PINE GROVE BEHAVIORAL HEALTH HEALTHCARE HUMAN RESOURCES NPI 1255924346

NPI Information

NPI: 1255924346
Provider Name: PINE GROVE BEHAVIORAL HEALTH HEALTHCARE HUMAN RESOURCES

Doing Business As: FORREST GENERAL HOSPITAL

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2255 BROADWAY DR
HATTIESBURG, MS
ZIP 39402
Phone: (601) 288-2273
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PINE GROVE BEHAVIORAL HEALTH HEALTHCARE HUMAN RESOURCES is a mental health counselor in Hattiesburg, MS. PINE GROVE BEHAVIORAL HEALTH HEALTHCARE HUMAN RESOURCES NPI is 1255924346. The provider is registered as an organization entity type.
The provider Is Doing Business As Forrest General Hospital.

The provider's business location address is:

2255 BROADWAY DR
HATTIESBURG, MS
ZIP 39402-254
Phone: (601) 288-2273

The provider's authorized official is Jacob Cornelius Parker .
The authorized official title is Psychiatrist and has the following contact phone number (601) 288-2273.

The CLIA number assigned to this NPI record is 25D1065657 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2021 and was last updated on 9/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	347C00000X	Private Vehicle				No
2	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	800347	OTHER	MISSISSIPPI	HEALTHCARE EMPLOYER PROVIDER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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