Active NPI
Addiction Campuses of Mississippi, LLC
- Substance Use Disorder Rehabilitation Clinic/Center
- Southaven, MS
National Provider Identifier
1487067237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- Legal business name
- ADDICTION CAMPUSES OF MISSISSIPPI, LLC
- Practice address
- 478 Marathon Way Ste 4
Southaven, MS 38671-9523 - Phone
- (662) 510-5980
- Fax
- (662) 510-5965
- NPI assigned
- Jun 10, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark Edwards
- Title
- Cfo
- Phone
- (205) 244-8112
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Primary | ||
| Substance Abuse Rehabilitation Facility | 324500000X |
Addresses
Primary practice location
478 Marathon Way Ste 4
Southaven, MS 38671-9523
Mailing address
1 Perimeter Park S Ste 200
Birmingham, AL 35243-2327
Phone (205) 251-7753
Other names 1
- Woodland Recovery Center
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D1107590 | Woodland Recovery Center, the | Certificate of waiver | Nov 8, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Addiction Campuses of Mississippi LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Abuse Rehabilitation Facility
- Southaven, MS
- NPI 1356703524
Locations
478 Marathon Way
Ste 4
Southaven, MS 38671
Phone (662) 510-5980
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Social Worker
- Southaven, MS
- NPI 1033796172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771804800000",
"number": "1487067237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PERIMETER PARK S STE 200",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352432327",
"telephone_number": "205-251-7753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "478 MARATHON WAY STE 4",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386719523",
"telephone_number": "662-510-5980",
"fax_number": "662-510-5965"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADDICTION CAMPUSES OF MISSISSIPPI, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-06-10",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A",
"authorized_official_last_name": "EDWARDS",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "205-244-8112"
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"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": "Woodland Recovery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.