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?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management