Provider Demographics
NPI:1013213594
Name:RELIANT, INC.
Entity Type:Organization
Organization Name:RELIANT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:601-906-9052
Mailing Address - Street 1:105 SUMMIT GRV
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-7384
Mailing Address - Country:US
Mailing Address - Phone:601-906-9052
Mailing Address - Fax:
Practice Address - Street 1:3825 HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-4232
Practice Address - Country:US
Practice Address - Phone:769-777-4400
Practice Address - Fax:769-777-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02823259Medicaid