MIND REPOSE LLC NPI 1609528272

NPI Information

NPI: 1609528272
Provider Name: MIND REPOSE LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
120 W SCENIC DR
PASS CHRISTIAN, MS
ZIP 39571
Phone: (480) 300-2655
Get Directions

MIND REPOSE LLC is a substance abuse rehabilitation facility in Pass Christian, MS. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MIND REPOSE LLC NPI is 1609528272. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

120 W SCENIC DR
PASS CHRISTIAN, MS
ZIP 39571-420
Phone: (480) 300-2655

The provider's authorized official is Daniel Case .
The authorized official title is Ceo and has the following contact phone number (480) 300-2655.

The enumeration date for this NPI number is 1/25/2022 and was last updated on 1/25/2022.

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	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	102L00000X	Psychoanalyst		No
3	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	No
4	103TB0200X	Psychologist	Cognitive & Behavioral	No
5	103TC0700X	Psychologist	Clinical	No
6	103TC1900X	Psychologist	Counseling	No
7	103TP0016X	Psychologist	Prescribing (Medical)	No
8	103TP0814X	Psychologist	Psychoanalysis	No
9	103TP2701X	Psychologist	Group Psychotherapy	No
10	103TR0400X	Psychologist	Rehabilitation	No
11	163WA0400X	Registered Nurse	Addiction (Substance Use Disorder)	No
12	207QA0401X	Family Medicine	Addiction Medicine	No
13	2084A0401X	Psychiatry & Neurology	Addiction Medicine	No
14	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
15	324500000X	Substance Abuse Rehabilitation Facility		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	1134710817	OTHER	MISSISSIPPI	STATE OF MISSISSIPPI

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: 5/5/2024

NPI Synchronization or Removal

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