Provider Demographics
NPI: | 1801386487 |
---|---|
Name: | SUNFLOWER-HUMPHREYS COUNTIES PROGRESS, INC. |
Entity Type: | Organization |
Organization Name: | SUNFLOWER-HUMPHREYS COUNTIES PROGRESS, INC. |
Other - Org Name: | SUNFLOWER-HUMPHREYS COUNTIES PROGRESS, INC. |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | CHRISTOPHER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CARPENTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 662-887-1431 |
Mailing Address - Street 1: | PO BOX 908 |
Mailing Address - Street 2: | |
Mailing Address - City: | INDIANOLA |
Mailing Address - State: | MS |
Mailing Address - Zip Code: | 38751-0908 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 662-887-1431 |
Mailing Address - Fax: | 662-887-4888 |
Practice Address - Street 1: | 414 MARTIN LUTHER KING DR |
Practice Address - Street 2: | |
Practice Address - City: | INDIANOLA |
Practice Address - State: | MS |
Practice Address - Zip Code: | 38930 |
Practice Address - Country: | US |
Practice Address - Phone: | 662-887-1431 |
Practice Address - Fax: | 662-887-4888 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-05-18 |
Last Update Date: | 2018-05-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management |