ELLISVILLE STATE SCHOOL NPI 1568468080

NPI Information

  • NPI: 1568468080
  • Provider Name: ELLISVILLE STATE SCHOOL
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 1101 HWY 11 S
    ELLISVILLE, MS
    ZIP 39437
  • Phone: (601) 477-9384

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NPI Details

ELLISVILLE STATE SCHOOL is a clinic center in Ellisville, MS. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ELLISVILLE STATE SCHOOL NPI is 1568468080. The provider is registered as an organization entity type.

The provider's business location address is:

1101 HWY 11 S
ELLISVILLE, MS
ZIP 39437-444
Phone: (601) 477-9384
Fax: (601) 477-5700

The provider's authorized official is Suzie Lassiter .
The authorized official title is Director and has the following contact phone number (601) 477-9384.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 8/22/2020.

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 License Number License State Primary
1261Q00000XClinic/CenterC00638MISSISSIPPIYes

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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