| Ancor Corporation | |
|
500 Desoto Ave Clarksdale MS 38614-5217 | |
| (662) 627-5317 | |
| Not Available |
| Full Name | Ancor Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 500 Desoto Ave, Clarksdale, Mississippi |
| Authorized Official Name and Position | Bertrand Antoine (PRESIDENT) |
| Authorized Official Contact | 6626275317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ancor Corporation 500 Desoto Ave Clarksdale MS 38614-5217 Ph: (662) 627-5317 | Ancor Corporation 500 Desoto Ave Clarksdale MS 38614-5217 Ph: (662) 627-5317 |
| NPI Number | 1912238437 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 01/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912238437 | NPI | - | NPPES |
| 07427785 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 07427785 (Mississippi) | Primary |
Region One Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1742 Cheryl St, Clarksdale, MS 38614 Phone: 662-627-7267 Fax: 662-627-5240 | |
Region One Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1742 Cheryl St, Clarksdale, MS 38614 Phone: 662-627-7267 Fax: 662-627-5240 |