Care Clinic For Drug Addiction & Mental Health In North Mississippi
Internal Medicine, Addiction Medicine in Southaven, MS. Organization (NPI-2).
NPI number1659041663
StatusActive
Last updated in NPPESAug 31, 2022
Details
- NPI
- 1659041663
- Entity type
- Organization (NPI-2)
- Legal business name
- Care Clinic For Drug Addiction & Mental Health In North Mississippi
- Organization subpart
- No
- Enumeration date
- Sep 20, 2021
- Certification date
- Jul 26, 2022
- Last updated
- Aug 31, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RA0401X | Internal Medicine, Addiction Medicine | – | – | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
8829 Centre St Ste 200Southaven, MS 38671-2610
Phone 662-934-8671
Mailing address
222 Southlakes DrGrenada, MS 38901-8499
Phone 662-934-8671
Authorized official
Cedric Edwards
Medical Director
6629348671
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.