Beacon Behavioral of Mississippi, LLC
NPI #1891532305 in Olive Branch, Mississippi
Provider Information
- NPI Number
- 1891532305
- Entity Type
- Organization
- Organization Name
- Beacon Behavioral of Mississippi, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BEACON BEHAVIORAL OF MISSISSIPPI, LLC
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Jul 11, 2024
- Last Updated
- Jul 11, 2024
Practice Location
- Address
- 9035 E SANDIDGE RD STE 201
- City
- Olive Branch
- State
- Mississippi
- ZIP Code
- 38654-3563
- Phone
- (662) 408-4631
Authorized Official
- Name
- KIMBERLY GLAVESKAS
- Title
- CREDENTIALING SUPERVISOR
- Phone
- (443) 962-3945
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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