BRADFORD RIVER BEND LLC NPI 1417576596

NPI Information

NPI: 1417576596
Provider Name: BRADFORD RIVER BEND, LLC
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
Doing Business As: THE ESTATE AT RIVER BEND
Address: 226 LOWE LN
LUCEDALE, MS
ZIP 39452
Phone: (601) 791-5135

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NPI Details

BRADFORD RIVER BEND, LLC is a rehabilitation and substance use disorder clinic center in Lucedale, MS. BRADFORD RIVER BEND, LLC NPI is 1417576596. The provider is registered as an organization entity type.
The provider Is Doing Business As The Estate At River Bend.

The provider's business location address is:

226 LOWE LN
LUCEDALE, MS
ZIP 39452-313
Phone: (601) 791-5135
Fax: (601) 791-5140

The provider's authorized official is Mark Edwards .
The authorized official title is Cfo and has the following contact phone number (205) 244-8112.

The enumeration date for this NPI number is 4/9/2020 and was last updated on 6/19/2024.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes
2	276400000X	Rehabilitation, Substance Use Disorder Unit		No
3	324500000X	Substance Abuse Rehabilitation Facility		No

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: 11/21/2025

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