GULF COAST MENTAL HEALTH CENTER (NPI# 1083101216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083101216 |
| Entity Type | Organization |
| Organization Name | GULF COAST MENTAL HEALTH CENTER |
| Practice Address |
15094 County Barn Road Gulfport MS 39503 |
| Mailing Address |
1600 Broad Ave Gulfport MS 39501-3603 |
| Practice Telephone | 2288630091 |
| Practice Fax Number | 2288642241 |
| Mailing Telephone | 2288631132 |
| Mailing Fax Number | 2288651700 |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-04-13 |
| Authorized Official Name | MANDY J MCDONALD (BILLING SUPERVISOR) |
| Authorized Official Telephone | 2288631132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | M8723 | MS | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124520549 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 819b Central Ave, Bay St Louis, MS 39520-3913 | 2018-03-01 |
| 1598127771 | Gulf Coast Mental Health Center | Psychologist | 1110 42nd Ave, Gulfport, MS 39501-2663 | 2016-03-25 |
| 1417934175 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2005-12-23 |
| 1962995860 | Gulf Coast Mental Health Center | Community/Behavioral Health | 15094 County Barn Road, Gulfport, MS 39503 | 2018-06-14 |
| 1548765670 | Gulf Coast Mental Health Center | Physical Therapist | 1600 Broad Avenue, Gulfport, MS 39501 | 2018-03-29 |
| 1467956037 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-20 |
| 1821591728 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-16 |
| 1649773540 | Gulf Coast Mental Health Center | Community/Behavioral Health | 1600 Broad Avenue, Gulfport, MS 39501-3603 | 2018-03-16 |
| 1386057628 | Gulf Coast Mental Health Center | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2014-06-04 |
| 1861715773 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2010-03-05 |
| Street Address |
15094 COUNTY BARN ROAD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962995860 | Gulf Coast Mental Health Center | Community/Behavioral Health | 15094 County Barn Road, Gulfport, MS 39503 | 2018-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| 1902257421 | Carlos Evers | Specialist/Technologist | 14046 North White Swan Dr, Gulfport, MS 39503 | 2016-06-27 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538792932 | Springwood Health & Supportive Living Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6447 Cheyenne Dr, Olive Branch, MS 38654-5172 | 2020-02-14 |
| 1255890695 | Boswell Regional Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1049 Simpson Highway 149, Magee, MS 39111-9644 | 2019-03-15 |
| 1871088922 | Tate Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1105 Laura Ave, Jackson, MS 39209-7008 | 2018-06-29 |
| 1124520549 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 819b Central Ave, Bay St Louis, MS 39520-3913 | 2018-03-01 |
| 1659790152 | Light of The World Adult Day Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 W Gresham St, Indianola, MS 38751-2053 | 2014-04-11 |
| 1518386440 | Sharon Jones | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 322 Dianne Dr, Diberville, MS 39540-3712 | 2014-04-08 |
| 1053682724 | Center for Family Life Extension, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1160 Mclean St, Jackson, MS 39209-7251 | 2012-01-26 |
| 1750684742 | Angela F. Holmes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1421 Mary St, Greenville, MS 38701-7148 | 2010-12-13 |
| 1417464512 | Community Living In Mississippi - Baddour | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3297 Highway 51 S, Senatobia, MS 38668-2926 | 2018-01-10 |
| 1215341979 | Methodist Home Road Assisted Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4560 Methodist Home Rd, Jackson, MS 39213-4201 | 2014-06-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.