Provider Demographics
NPI:1255506705
Name:REGION SEVEN MENTAL HEALTH INTELLECTUAL DISABILITIES COMM
Entity type:Organization
Organization Name:REGION SEVEN MENTAL HEALTH INTELLECTUAL DISABILITIES COMM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING/ACCTS REC SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-323-9318
Mailing Address - Street 1:PO BOX 1336
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-1336
Mailing Address - Country:US
Mailing Address - Phone:662-524-4347
Mailing Address - Fax:662-524-4370
Practice Address - Street 1:120 COLLIER ROAD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-8891
Practice Address - Country:US
Practice Address - Phone:662-323-8907
Practice Address - Fax:662-323-9841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS000770280Medicaid