ADDICTION CAMPUSES PROFESSIONAL SERVICES OF MISSISSIPPI, LLC


Address: 340 Stateline Rd W, Southaven, MS 38671-1610
Phone: 6625105387

ADDICTION CAMPUSES PROFESSIONAL SERVICES OF MISSISSIPPI, LLC (NPI# 1659990075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659990075
Entity Type Organization
Organization Name ADDICTION CAMPUSES PROFESSIONAL SERVICES OF MISSISSIPPI, LLC
Practice Address 340 Stateline Rd W
Southaven
MS 38671-1610
Mailing Address 205 Reidhurst Ave
Nashville
TN 37203-1618
Practice Telephone 6625105387
Practice Fax Number 6623420782
Enumeration Date 2020-04-15
Last Update Date 2020-08-17
Authorized Official Name LEIGH ANN THOMPSON (SENIOR DIRECTOR)
Authorized Official Telephone 6159214447
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084A0401X Psychiatry & Neurology
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 340 STATELINE RD W
City SOUTHAVEN
State MS
Zip Code 38671-1610

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700088085 Kallol Kumar Saha Family Medicine 340 Stateline Rd W, Southaven, MS 38671-1610 2007-05-31
1851916837 Amanda Folsom Nurse Practitioner 340 Stateline Rd W, Southaven, MS 38671-1610 2020-06-15
1831728583 Treneise Hunt-smith Nurse Practitioner 340 Stateline Rd W, Southaven, MS 38671-1610 2020-04-05
1164083747 Jennifer Gail Ross Nurse Practitioner 340 Stateline Rd W, Southaven, MS 38671-1610 2019-06-25
1073035168 Jerry D Williams II Nurse Practitioner 340 Stateline Rd W, Southaven, MS 38671 2017-07-11
1356703524 Addiction Campuses of Mississippi, LLC Substance Abuse Rehabilitation Facility 340 Stateline Rd W, Southaven, MS 38671-1610 2016-03-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285196196 Emma Tinsley-bowles Long Social Worker 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 2019-04-01
1851847586 Tiffany Lashea Jones Adult Companion 8755 Millbranch Road, Southaven, MS 38671 2016-09-01
1538526140 Desoto Pediatric Extended Care LLC Skilled Nursing Facility 750 Stateline Road East, Southhaven, MS 38671 2016-01-27
1073983052 Tara Burt Physical Therapist 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 2015-10-02
1295160463 Ideal Community Care,llc In Home Supportive Care 8869 Centre Str #3, Southaven, MS 38671 2013-09-06
1578995692 Gregory Charles Eakins Jr. Optometrist 338 Goodman Rd West, Southaven, MS 38671 2013-07-31
1295173169 Erica R. Martin Social Worker 975 Swinnea Rdg Ste 3, Southaven, MS 38671 2013-06-12
1386918431 Freds Stores of Tennessee Inc Pharmacy 710 Church Road, Southaven, MS 38671 2012-03-06
1740565613 Mary Jeanette Scruggs Pharmacist 1011 Goodman Rd, Southaven, MS 38671 2011-10-11
1184919268 First Pharmacy Services 5 Pharmacy 5185a Getwell Rd, Southaven, MS 38671 2011-06-16
Find all providers in zip 38671

Taxonomy Information

Taxonomy Code 2084A0401X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Addiction Medicine

Taxonomy Definition

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1578709713 Holloway Psychiatric Services, Inc. Psychiatry & Neurology 742d Magnolia St, Madison, MS 39110-8903 2008-12-17
1003955626 Scott L. Hambleton Psychiatry & Neurology 7048 Old Canton Road, Suite 2001, Ridgeland, MS 39157 2007-02-06
1558379263 Kevin Mark Passer Psychiatry & Neurology 5317-4 Old Highway 11, Hattiesburg, MS 39402 2006-08-04
1023034758 Elizabeth Connell Henderson Psychiatry & Neurology 3848 County Road 24, Hickory, MS 39332-2630 2006-07-14
1477180958 Wright and Associates Medical Logistics LLC Psychiatry & Neurology 1403 43rd Ave, Gulfport, MS 39501-2545 2020-03-25
1952940454 Magnolia Counseling Clinic Psychiatry & Neurology 590 Highway 6 E, Batesville, MS 38606-3002 2019-12-31
1497103469 Sharmayn Sayers-erfourth Psychiatry & Neurology 129 E Starling St Ste A, Greenville, MS 38701-4725 2016-05-31
1437327830 River Oaks Management Company, LLC Psychiatry & Neurology 207 W Jackson St, Suite 1, Ridgeland, MS 39157-2311 2008-02-19
1972642585 Randall L Sherman Psychiatry & Neurology 1 Lincoln Pkwy Ste 202, Hattiesburg, MS 39402-3261 2007-02-06
1922101328 Sreedhar Rao Rayudu Psychiatry & Neurology 590 Hwy 6 East, Batesville, MS 38606 2006-09-07
Find all providers with the same taxonomy

Competitor

Search similar providers

City SOUTHAVEN
Zip Code 38671

Improve Information

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Dataset Information

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.

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