| Memorial Behavioral Health | |
|
11150 Highway 49 Gulfport MS 39503-4110 | |
| (228) 575-1000 | |
| (228) 575-2002 |
| Full Name | Memorial Behavioral Health |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 11150 Highway 49, Gulfport, Mississippi |
| Authorized Official Name and Position | Michelle E Johnson (OFFICE MANAGER) |
| Authorized Official Contact | 2285751970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Behavioral Health 11150 Highway 49 Gulfport MS 39503-4110 Ph: (228) 575-1000 | Memorial Behavioral Health 11150 Highway 49 Gulfport MS 39503-4110 Ph: (228) 575-1000 |
| NPI Number | 1649685561 |
|---|---|
| Provider Enumeration Date | 06/30/2014 |
| Last Update Date | 06/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649685561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C6816 (Mississippi) | Primary |
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