| Mantachie Rural Health Care Inc Behavioral Health | |
|
5510 Hwy 363 Mantachie MS 38855 | |
| (662) 282-4226 | |
| (662) 282-7946 |
| Full Name | Mantachie Rural Health Care Inc Behavioral Health |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5510 Hwy 363, Mantachie, Mississippi |
| Authorized Official Name and Position | Karen Crabb Burns (OFFICE MANAGER) |
| Authorized Official Contact | 6622824226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mantachie Rural Health Care Inc Behavioral Health 5510 Hwy 363 Mantachie MS 38855 Ph: (662) 282-4226 | Mantachie Rural Health Care Inc Behavioral Health 5510 Hwy 363 Mantachie MS 38855 Ph: (662) 282-4226 |
| NPI Number | 1720589070 |
|---|---|
| Provider Enumeration Date | 02/22/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720589070 | NPI | - | NPPES |
| 08581013 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mantachie Rural Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5681 Highway 363, Mantachie, MS 38855 Phone: 662-282-4226 Fax: 662-282-7946 | |
Mantachie Rural Health Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 311 Mustang Drive, Mantachie, MS 38855 Phone: 662-282-7161 Fax: 662-282-7536 | |
Mantachie Rural Health Care, Inc. Dental Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5500 Hwy 363, Mantachie, MS 38855 Phone: 662-282-4226 Fax: 662-282-7946 | |
Mantachie Rural Health Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5681 Highway 363, Mantachie, MS 38855 Phone: 662-282-4226 |