Bradford River Bend, LLC | NPI 1194569855

Key facts

NPI: 1194569855
Entity type: Organization (NPI type 2)
Primary specialty: Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name: BRADFORD RIVER BEND, LLC
Practice address: 330 Highway 90
Gautier, MS 39553-5705
Phone: (601) 791-5135
NPI assigned: Jun 19, 2024
Organization subpart: No

Authorized official

Name: Mark Edwards
Title: Cfo
Phone: (205) 244-8112

Corporate family (same tax ID) 1

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

Bradford River Bend, LLC Substance Use Disorder Rehabilitation Clinic/Center · Lucedale, MS · NPI 1417576596

NPD tax ID

Practitioners 3

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

Donald C Faucett, M.D. Ophthalmology Physician · Ridgeland, MS · NPI 1609960889

NPD (past)
Christopher M Gilmore, FNP-BC Family Nurse Practitioner · Gulfport, MS · NPI 1972320604

NPD (past)
Elise Bowie Sisson Family Nurse Practitioner · Pascagoula, MS · NPI 1447958061

NPD (past)

National Provider Directory

Tax ID family: Bradford River Bend Dba the Estate at River Bend (2 organizations share this tax ID)

Locations

330 Highway 90
Gautier, MS 39553
Phone (601) 791-5135

330 Highway 90
Ste B
Gautier, MS 39553

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Substance Use Disorder Rehabilitation Clinic/Center	261QR0405X			Yes
Substance Abuse Rehabilitation Facility	324500000X

Addresses

Primary practice location

330 Highway 90
Gautier, MS 39553-5705

Mailing address

1 Perimeter Park S Ste 200
Birmingham, AL 35243-2327
Phone (205) 251-7753

Other names

The Estate at River Bend Doing business as

Other providers in Gautier, MS

Estella L Bolton
Alicia Diane Bonner, B.A.
Vicki Booker, PHARMD
Mykayla Boone
Kenny Joseph Boudreaux, BA. B.S. PSYCHOLOGY
Linda Lashawn Bradley, MS
Linda Gail Bratcher, MS
Clifford Wayne Brewer, O.D.
Brandon Brown
Lakendra A Brown

All providers in Gautier, MS · Substance Use Disorder Rehabilitation Clinic/Center in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.