NPIMap

Organization Active NPI

Modern Recovery, Inc.

  • Adult Mental Health Clinic/Center
  • Ridgeland, MS
National Provider Identifier
1467119644
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MODERN RECOVERY, INC.
Practice address
1000 Highland Colony Pkwy Ste 5203
Ridgeland, MS 39157-2079
Phone
(844) 991-0555
NPI assigned
Nov 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Andre Bahbah
Title
Director of RCM
Phone
(754) 270-6654

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

1000 Highland Colony Pkwy Ste 5203
Ridgeland, MS 39157-2079

Mailing address

1000 Highland Colony Pkwy Ste 5203
Ridgeland, MS 39157-2079

Other names 1

  • Virgil- Ridgeland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Recovery Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1467119644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIGHLAND COLONY PKWY STE 5203",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHLAND COLONY PKWY STE 5203",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572079",
            "telephone_number": "844-991-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "BAHBAH",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "754-270-6654"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virgil- Ridgeland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.