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25D0960045 CLIA NUMBER - MILLCREEK REHABILITATION CENTER

Laboratory Demographics

CLIA Number: 25D0960045

Facility Name: MILLCREEK REHABILITATION CENTER

Facility Address:
900 FIRST AVE NE
MAGEE, MS
ZIP 39111
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Facility Phone Number: 601 849-4221

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver
NPI Number: 1487762076

Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

CLIA Record

Field Name Field Value
CLIA Number 25D0960045
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name MILLCREEK REHABILITATION CENTER
Street 900 FIRST AVE NE
City MAGEE
State MS
ZIP 39111
Phone 601 849-4221
CertificateType 4
CertificateEffectiveDate 4/27/2023
CertificateExpirationDate 4/26/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024