Provider Demographics
NPI:1114291929
Name:POSITIVE LIVING, INC.
Entity Type:Organization
Organization Name:POSITIVE LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-209-7990
Mailing Address - Street 1:PO BOX 11503
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39283-1503
Mailing Address - Country:US
Mailing Address - Phone:601-209-7990
Mailing Address - Fax:601-366-5949
Practice Address - Street 1:3811 W NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39209-2560
Practice Address - Country:US
Practice Address - Phone:601-209-7990
Practice Address - Fax:601-366-5949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children