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Region 12 Commission On Mental Health And Retardation
Substance Abuse Rehabilitation Facility in Moselle, Mississippi
NPI 1982612206

Region 12 Commission On Mental Health And Retardation is a Substance Abuse Rehabilitation Facility based in Hattiesburg, MS. Region 12 Commission On Mental Health And Retardation practices in Moselle, MS. The NPI Number for Region 12 Commission On Mental Health And Retardation is 1982612206 and holds a License No. R12-DADA-PR-TR-OP-01 (Mississippi).

The current practice location address for Region 12 Commission On Mental Health And Retardation is 3 Clearview Cir, Moselle, MS and can be reached out via phone at 601-544-1499 and via fax at 601-584-4053.

Location: 3 Clearview Cir, Moselle, MS, 39403-1030
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1982612206
Provider Name
Region 12 Commission On Mental Health And Retardation
Credential
Provider Entity Type
Organization
Address
3 Clearview Cir, Moselle, MS, 39403-1030
Phone Number
601-544-1499
Fax Number
601-584-4053
Provider Enumeration Date
08/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00018212 05 MS
20463 01 MS BC/BS PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
3 Clearview Cir
City
Moselle
State
Mississippi
Zip
39459-9520
Phone Number
601-544-1499
Fax Number
601-584-4053
person
Provider Business Mailing Address Details
Address
3 Clearview Cir
City
Moselle
State
Mississippi
Zip
39459-9520
Phone Number
601-544-1499
Fax Number
601-584-4053
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
R12-DADA-PR-TR-OP-01 (Mississippi)
Definition
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.
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