Provider Demographics
NPI:1477069037
Name:SOUTHERN CHRISTIAN SERVICES FOR CHILDREN AND YOUTH, INC.
Entity Type:Organization
Organization Name:SOUTHERN CHRISTIAN SERVICES FOR CHILDREN AND YOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:CELENE
Authorized Official - Last Name:HIMES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-354-0983
Mailing Address - Street 1:860 E RIVER PL STE 104
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-3442
Mailing Address - Country:US
Mailing Address - Phone:601-354-0983
Mailing Address - Fax:
Practice Address - Street 1:860 E RIVER PL STE 104
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-3442
Practice Address - Country:US
Practice Address - Phone:601-354-0983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)