EXTRA MILE RECOVERY (NPI# 1164948196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164948196 |
| Entity Type | Organization |
| Organization Name | EXTRA MILE RECOVERY |
| Practice Address |
720 Oak Grove Rd Mantachie MS 38855-8469 |
| Practice Telephone | 6623212329 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Authorized Official Name | MR. RODNEY L FARRAR (EXECUTIVE/CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6623212329 |
| Authorized Official Credential | LPC, NCC, CADC-I |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
720 OAK GROVE RD |
| City | MANTACHIE |
| State | MS |
| Zip Code | 38855-8469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1053885673 | Mantachie Rural Health Care, Inc | Clinic/Center | 311 Mustang Drive, Mantachie, MS 38855 | 2019-01-16 |
| 1992292536 | Mantachie Pharmacy LLC | Pharmacy | 3309 Highway 371 N, Mantachie, MS 38855 | 2018-04-19 |
| 1720589070 | Mantachie Rural Health Care Inc Behavioral Health | Clinic/Center | 5510 Hwy 363, Mantachie, MS 38855 | 2018-02-22 |
| 1962816447 | Travis Castleberry | Physical Therapist | 230a Main Street, Nettleton, MS 38855 | 2014-06-12 |
| 1891907093 | Community Family Healthcare, Inc | Nurse Practitioner | 285 Ivie Lane, Mantachie, MS 38855 | 2007-05-03 |
| 1750307328 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 67 Watson Dr, Mantachie, MS 38855 | 2006-07-15 |
| 1497063085 | Jennifer Emily Bass | Specialist | 275 Morning View Lane, Mantachie, MS 38855-7096 | 2010-09-17 |
| 1780169557 | Andrea Carpenter | Nurse Practitioner | 3275 Highway 371 N, Mantachie, MS 38855-7145 | 2018-09-27 |
| 1164987426 | Hometown Care of Mantachie LLC | Nurse Practitioner | 3275 Highway 371 N, Mantachie, MS 38855-7145 | 2019-01-31 |
| Find all providers in zip 38855 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1861047250 | Defining Wellness Centers Inc. | Substance Abuse Rehabilitation Facility | 630 Lakeland East Dr Ste A, Flowood, MS 39232-9565 | 2019-08-03 |
| 1093284598 | Safe Harbor Recovery and Counseling LLC | Substance Abuse Rehabilitation Facility | 123 Westover Dr, Hattisburg, MS 39402-1329 | 2018-11-14 |
| 1891149738 | Stonewater Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 38 County Road 362, Oxford, MS 38655-8514 | 2016-04-18 |
| 1386042471 | Recovery House, Inc. | Substance Abuse Rehabilitation Facility | 770 Golding Road, Columbus, MS 39704-2590 | 2014-12-05 |
| 1487067237 | Addiction Campuses of Mississippi, LLC | Substance Abuse Rehabilitation Facility | 7185 Swinnea Rd, Southaven, MS 38671-6003 | 2014-06-10 |
| 1518206440 | Alcohol Services Center, Inc. | Substance Abuse Rehabilitation Facility | 950 N West St, Jackson, MS 39202-2566 | 2013-02-13 |
| 1023373586 | Clever Recovery | Substance Abuse Rehabilitation Facility | 185 Foxtrail Rd, Picayune, MS 39466-9027 | 2012-07-11 |
| 1669603593 | Harbor Houses of Jackson, Inc. | Substance Abuse Rehabilitation Facility | 5354 I 55 S, Jackson, MS 39272-9119 | 2009-07-27 |
| 1760610109 | Frontline Recovery, LLC | Substance Abuse Rehabilitation Facility | 1038 River Ridge Rd, Summit, MS 39666-9715 | 2009-06-24 |
| 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.