Provider Demographics
NPI:1295185395
Name:REGION 6 COMMUNITY MENTAL HEALTH COMMISSION
Entity Type:Organization
Organization Name:REGION 6 COMMUNITY MENTAL HEALTH COMMISSION
Other - Org Name:LIFE HELP MYPAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHAEDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-453-6211
Mailing Address - Street 1:PO BOX 1505
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38935-1505
Mailing Address - Country:US
Mailing Address - Phone:662-453-6211
Mailing Address - Fax:662-453-2558
Practice Address - Street 1:2504 BROWNING ROAD 520
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-6022
Practice Address - Country:US
Practice Address - Phone:662-453-6211
Practice Address - Fax:662-453-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health