Mmo Of Hattiesburg, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Hattiesburg, MS. Organization (NPI-2).
NPI number1629022017
StatusActive
Last updated in NPPESJul 2, 2010
Details
- NPI
- 1629022017
- Entity type
- Organization (NPI-2)
- Legal business name
- Mmo Of Hattiesburg, LLC
- Organization subpart
- No
- Enumeration date
- May 20, 2006
- Last updated
- Jul 2, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Delta Medical Systems, LLC (Former Legal Business Name)
Practice location
990 Hardy StSuite 4
Hattiesburg, MS 39401-4161
Phone 601-602-0194 · Fax 601-602-0197
Mailing address
728 North BlvdBaton Rouge, LA 70802-5724
Phone 225-293-6774 · Fax 225-291-9229
Authorized official
Robert L. Miller
Ceo
2252936774
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All 8 Mental Health Clinic/Center (Including Community Mental Health Center) providers in Hattiesburg · All 3,372 providers in Hattiesburg
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