Specialized Treatment Facility
NPI #1013922954 in Gulfport, Mississippi
Provider Information
- NPI Number
- 1013922954
- Entity Type
- Organization
- Organization Name
- Specialized Treatment Facility
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Jul 29, 2006
- Last Updated
- Dec 5, 2019
Practice Location
- Address
- 14426 JAMES BOND RD
- City
- Gulfport
- State
- Mississippi
- ZIP Code
- 39503-8311
- Phone
- (228) 328-6000
Authorized Official
- Name
- MRS. SHANNON Y BUSH, MPA
- Title
- PROGRAM DIRECTOR
- Phone
- (228) 328-6000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
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