NPIMap

Organization Active NPI

Southaven Services

  • Community/Behavioral Health Agency
  • Southaven, MS
National Provider Identifier
1003218058
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHAVEN SERVICES
Practice address
1326 Goodman Rd E
Southaven, MS 38671-9542
Phone
(662) 536-3132
NPI assigned
Sep 22, 2014
Organization subpart
Yes
Parent organization
REGION IV MENTAL HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Charlie D Spearman Sr.
Title
Executive Director
Phone
(662) 287-9883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1326 Goodman Rd E
Southaven, MS 38671-9542

Mailing address

PO Box 839
Corinth, MS 38835-0839
Phone (662) 286-9883

Other identifiers 1

IdentifierTypeStateIssuer
00018204MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Southaven Services31 organizations share this tax ID, including this one
Part of
Southaven Services

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Locations

1326 Goodman Rd E
Southaven, MS 38671
Phone (662) 536-3132

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1003218058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-286-9883",
            "fax_number": "662-284-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 GOODMAN RD E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719542",
            "telephone_number": "662-536-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHAVEN SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGION IV MENTAL HEALTH SERVICES",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "662-287-9883",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018204",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.