MDB BEHAVIORAL HEALTH SERVICES LLC NPI 1669835310

NPI Information

NPI: 1669835310
Provider Name: MDB BEHAVIORAL HEALTH SERVICES LLC

Doing Business As: COMPLETE CARE RURAL HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1911 MISSION 66 STE B
VICKSBURG, MS
ZIP 39180
Phone: (601) 665-4162
Get Directions

MDB BEHAVIORAL HEALTH SERVICES LLC is a rural health clinic center in Vicksburg, MS. MDB BEHAVIORAL HEALTH SERVICES LLC NPI is 1669835310. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Complete Care Rural Health Clinic.

The provider's business location address is:

1911 MISSION 66 STE B
VICKSBURG, MS
ZIP 39180-762
Phone: (601) 665-4162
Fax: (855) 830-3484

The provider's authorized official is Christopher J Watkins .
The authorized official title is Member and has the following contact phone number (601) 951-9863.

The CLIA number assigned to this NPI record is 25D1068392 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/31/2016 and was last updated on 9/6/2023.

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
1	2084P0800X	Psychiatry & Neurology	Psychiatry		MISSISSIPPI	No
2	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	007877558	MEDICAID	MISSISSIPPI
2	001583061	MEDICAID	MISSISSIPPI

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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »