Caleb Mountain Climbing Wholistic International Center LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CALEB MOUNTAIN CLIMBING WHOLISTIC INTERNATIONAL CENTER LLC

Practice address

610 Adeline St Ste 1a
Hattiesburg, MS 39401-3875

Phone

(601) 606-5771

Fax

(800) 489-0211

NPI assigned

Aug 24, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Bridget Y Tah-Clayton, DO

Title

Owner

Phone

(601) 606-5771

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Solid-Rock Comprehensive Healthcare Doing business as

Locations

Practitioners 3

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

• Jamelia A Durr

  • Case Manager/Care Coordinator
  • Hattiesburg, MS
  • NPI 1497433536
  NPD
• Sarah Arleen Scott

  • Pastoral Counselor
  • Hattiesburg, MS
  • NPI 1225751696
  NPD
• Mychal Prater

  • Mental Health Counselor
  • Biloxi, MS
  • NPI 1154043990
  NPD (past)

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

{
    "created_epoch": "1566604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566604800000",
    "number": "1487201372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ADELINE ST STE 1A",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013875",
            "telephone_number": "601-606-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ADELINE ST STE 1A",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013875",
            "telephone_number": "601-606-5771",
            "fax_number": "800-489-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALEB MOUNTAIN CLIMBING WHOLISTIC INTERNATIONAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-24",
        "last_updated": "2019-08-24",
        "status": "A",
        "authorized_official_last_name": "TAH-CLAYTON",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-606-5771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122708",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Solid-Rock Comprehensive Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victor Cahill Jr.
• Anthony A Calabrese, PH.D.
• Patricia Calabrese, FPMHNP
• Leigh Hannah Calcote, PMHNP-BC
• Richard Charles Calderone, D.O.
• Trinity Calhoun
• Albert Calvin III, CRNA
• Gilben Enrique Camacho Pabon, MD
• Camellia Healthcare
• Pamela M Cameron, LCSW

• Multi-Specialty Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Multi-Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2019; 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.