Provider Demographics
NPI:1952662157
Name:AUTISM CENTER OF NORTH MISSISSIPPI, INC.
Entity Type:Organization
Organization Name:AUTISM CENTER OF NORTH MISSISSIPPI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:BA, RBT
Authorized Official - Phone:662-840-0974
Mailing Address - Street 1:146 S THOMAS ST
Mailing Address - Street 2:STE. C
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5328
Mailing Address - Country:US
Mailing Address - Phone:662-840-0974
Mailing Address - Fax:
Practice Address - Street 1:146 S THOMAS ST
Practice Address - Street 2:STE. C
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-5328
Practice Address - Country:US
Practice Address - Phone:662-840-0974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities