Provider Demographics
NPI:1336688845
Name:METRO TREATMENT OF MISSISSIPPI, LP
Entity Type:Organization
Organization Name:METRO TREATMENT OF MISSISSIPPI, LP
Other - Org Name:MERIDIAN TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-351-7080
Mailing Address - Street 1:2500 MAITLAND CENTER PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7224
Mailing Address - Country:US
Mailing Address - Phone:407-351-7080
Mailing Address - Fax:
Practice Address - Street 1:2419 10TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-5040
Practice Address - Country:US
Practice Address - Phone:407-351-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone