Provider Demographics
NPI:1700442779
Name:VA GULF COAST VETERANS HEALTHCARE
Entity Type:Organization
Organization Name:VA GULF COAST VETERANS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:228-523-5256
Mailing Address - Street 1:400 VETERANS AVE # MC122
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-2410
Mailing Address - Country:US
Mailing Address - Phone:228-523-5256
Mailing Address - Fax:228-523-5969
Practice Address - Street 1:400 VETERANS AVE # MC122
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2410
Practice Address - Country:US
Practice Address - Phone:228-523-5256
Practice Address - Fax:228-523-5969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSM9230OtherLMSW