Copac Addiction Services

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

R586986 Issued in MS

Legal business name

COPAC ADDICTION SERVICES

Practice address

3949 Highway 43 N
Brandon, MS 39047-7240

Phone

(601) 829-2500

Fax

(601) 829-4278

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Wanda Newton Johnson, CFNP

Title

Family Nurse Practitioner

Phone

(601) 829-2500

Specialties & licenses 1

Addresses

Tax ID family

Copac Addiction Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Copac Incorporated

  • Substance Abuse Rehabilitation Facility
  • Flowood, MS
  • NPI 1922127331
  NPD tax ID
• Copac, Inc.

  • Substance Abuse Rehabilitation Facility
  • Brandon, MS
  • NPI 1235270885
  NPD tax ID

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1073679817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5857 KRISTEN DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112831",
            "telephone_number": "601-956-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 HIGHWAY 43 N",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477240",
            "telephone_number": "601-829-2500",
            "fax_number": "601-829-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPAC ADDICTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "NEWTON",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "601-829-2500",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MS",
            "license": "R586986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Tullos Cook
• Jennifer Cooper, SLP
• Kimberly Garrett Cooper, RPT
• Monica Monique Cooper, PMHNP-BC
• Patricia Diane Cooper, DPT
• Copac, Inc.
• Coster Companion Care. LLC
• Haley M Couch, OT
• Sara Elizabeth Courtney, DNP, FNP-C
• Amanda Kim Covault, CRNA

• Substance Abuse Rehabilitation Facility in Brandon, MS
• Providers in Brandon, MS by specialty
• Substance Abuse Rehabilitation Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.