Organization Active NPI

Addiction Campuses of Mississippi, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Southaven, MS
National Provider Identifier
1487067237
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
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

Updated by the provider on Feb 23, 2026

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)CodeLicenseStatePrimary
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 Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1107590Woodland Recovery Center, the478 Marathon Way Ste 400, Southaven, MS 38671Certificate of waiverNov 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Addiction Campuses of Mississippi LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

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.

Verify at the official NPI Registry.