NPIMap

Organization Active NPI

Ms State Hospital Crisis Intervention Center-Brookhaven

  • Psychiatric Hospital
  • Brookhaven, MS
National Provider Identifier
1598943631
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
31-345 Issued in MS
Legal business name
MS STATE HOSPITAL CRISIS INTERVENTION CENTER-BROOKHAVEN
Practice address
725 Brookman Dr Ext
Brookhaven, MS 39601-2311
Phone
(601) 351-8000
Fax
(601) 351-8586
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Ms. Jacqueline King
Title
Provider Enrollment
Phone
(601) 351-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 31-345 MS Primary

Addresses

Primary practice location

725 Brookman Dr Ext
Brookhaven, MS 39601-2311

Mailing address

725 Brookman Dr Ext
Brookhaven, MS 39601-2311
Phone (601) 351-8000

National Provider Directory

National Provider Directory
Tax ID family
Jaquith Nursing Home - Jaquith Inn21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1598943631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BROOKMAN DR EXT",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012311",
            "telephone_number": "601-351-8000",
            "fax_number": "601-351-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BROOKMAN DR EXT",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012311",
            "telephone_number": "601-351-8000",
            "fax_number": "601-351-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS STATE HOSPITAL CRISIS INTERVENTION CENTER-BROOKHAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "601-351-8000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MS",
            "license": "31-345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.