| Gulf Coast Mental Health Center | |
|
1600 Broad Ave Gulfport MS 39501-3603 | |
| (228) 863-1132 | |
| (228) 865-1700 |
| Full Name | Gulf Coast Mental Health Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1600 Broad Ave, Gulfport, Mississippi |
| Authorized Official Name and Position | Mary E Jones (CFO) |
| Authorized Official Contact | 2288631132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Mental Health Center 1600 Broad Ave Gulfport MS 39501-3603 Ph: (228) 863-1132 | Gulf Coast Mental Health Center 1600 Broad Ave Gulfport MS 39501-3603 Ph: (228) 863-1132 |
| NPI Number | 1417934175 |
|---|---|
| Provider Enumeration Date | 12/23/2005 |
| Last Update Date | 09/21/2020 |
| Certification Date | 09/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417934175 | NPI | - | NPPES |
| C00120 | Other | MS | CENTER MEDICARE ID |
| 00018213 | Medicaid | MS | |
| QMP000005325798 | Other | MS | MOLINA MEDICAID |
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