| Christian Fellowship Home | |
|
918 Parkway Dr Wiggins MS 39577-8750 | |
| (601) 928-1871 | |
| Not Available |
| Full Name | Christian Fellowship Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 918 Parkway Dr, Wiggins, Mississippi |
| Authorized Official Name and Position | Terrell Berry Boone (OWNER) |
| Authorized Official Contact | 6019281871 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christian Fellowship Home 918 Parkway Dr Wiggins MS 39577-8750 Ph: (601) 928-1871 | Christian Fellowship Home 918 Parkway Dr Wiggins MS 39577-8750 Ph: (601) 928-1871 |
| NPI Number | 1689933764 |
|---|---|
| Provider Enumeration Date | 05/10/2012 |
| Last Update Date | 05/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689933764 | NPI | - | NPPES |
| 1063 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1063 (Mississippi) | Primary |
Wildflower Wellness & Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 506 Calvin Dees St, Wiggins, MS 39577 Phone: 601-528-1527 |