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Autospa-Healthy Youth Center

Organization Active NPI Family Nurse Practitioner · Clarksdale, MS

NPI 1063957751 · NPPES record last updated Jan 4, 2017

Key facts

NPI
1063957751
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
Legal business name
AUTOSPA-HEALTHY YOUTH CENTER
Practice address
1202 Desoto Ave
Suite a
Clarksdale, MS 38614
Phone
(662) 209-1202
Fax
(662) 483-1627
NPI assigned
Jan 4, 2017
Organization subpart
No

Authorized official

Name
Gregory Hoskins
Title
President
Phone
(662) 209-1202

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2147476A Healthy You Weight Loss & Wellness Center
1202 Desoto Avenue/Hwy 49, Clarksdale, MS 38614		Certificate of waiverApr 18, 2028

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 363LF0000X Yes

Addresses

Primary practice location

1202 Desoto Ave
Suite a
Clarksdale, MS 38614

Mailing address

1202 Desoto Ave
Suite a
Clarksdale, MS 38614
Phone (662) 209-1202

Other names

  • A HEALTHY YOU WEIGHTLOSS & WELLNESS CENTER Doing business as

Other providers in Clarksdale, MS

All providers in Clarksdale, MS · Family Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.