Provider Demographics
NPI:1003326158
Name:REGION TEN STATE OF MS
Entity Type:Organization
Organization Name:REGION TEN STATE OF MS
Other - Org Name:WEEMS COMMUNITY MENTAL HEALTH ADULT DAY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-483-4821
Mailing Address - Street 1:PO BOX 4378
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39304-4378
Mailing Address - Country:US
Mailing Address - Phone:601-483-4821
Mailing Address - Fax:601-485-0223
Practice Address - Street 1:701 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MS
Practice Address - Zip Code:39345-2361
Practice Address - Country:US
Practice Address - Phone:601-683-4320
Practice Address - Fax:601-485-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care