MR. ALFRED CONWAY PORTER MBA NPI 1740756758

NPI Information

MR. Alfred Conway Porter, MBA is an assisted living and mental illness assisted living facility in Jackson, MS. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. MR. Alfred Conway Porter, MBA NPI is 1740756758. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3201 HOLLYWOOD AVE
JACKSON, MS
ZIP 39213-754
Phone: (601) 665-3402

The enumeration date for this NPI number is 10/17/2018 and was last updated on 10/17/2018.

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:

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