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CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI NPI 1659041663


NPI Information

NPI: 1659041663
Provider Name: CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 25D2239512

Address:
8829 CENTRE ST STE 200
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 934-8671
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CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI is an addiction medicine internal medicine in Southaven, MS. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI NPI is 1659041663. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8829 CENTRE ST STE 200
SOUTHAVEN, MS
ZIP 38671-610
Phone: (662) 934-8671

The provider's authorized official is Cedric Edwards .
The authorized official title is Medical Director and has the following contact phone number (662) 934-8671.

The CLIA number assigned to this NPI record is 25D2239512 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2021 and was last updated on 8/31/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
2207RA0401XInternal MedicineAddiction MedicineYes

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

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