My Brother's Keeper, INC

NPI #1215603139 in Hattiesburg, Mississippi

Provider Information

NPI Number: 1215603139
Entity Type: Organization
Organization Name: My Brother's Keeper, INC
Subpart: Yes (part of a larger organization)
Parent Organization: MY BROTHER'S KEEPER, INC
Primary Specialty: Clinic/Center
Enumeration Date: Aug 19, 2021
Last Updated: Aug 19, 2021

Practice Location

Address: 1711 HARDY ST
City: Hattiesburg
State: Mississippi
ZIP Code: 39401-4910
Phone: (769) 216-2455

Authorized Official

Name: JUNE A GIPSON, PHD
Title: PRESIDENT/CEO
Phone: (769) 216-2455

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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