NPIMap

Organization Active NPI

Region XII Comm on Mental Health Dba Pine Belt Mental Healthcare

  • Developmentally Disabled Services Day Training Agency
  • Hattiesburg, MS
National Provider Identifier
1689847394
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
REGION XII COMM ON MENTAL HEALTH DBA PINE BELT MENTAL HEALTHCARE
Practice address
103 S 19TH Ave
Hattiesburg, MS 39401-6171
Phone
(601) 544-4641
Fax
(601) 584-4053
NPI assigned
Apr 3, 2008
Last updated
Apr 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Janet Mays
Title
Cfo
Phone
(601) 544-4641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

103 S 19TH Ave
Hattiesburg, MS 39401-6171

Mailing address

PO Box 1030
Hattiesburg, MS 39403-1030

Other identifiers 1

IdentifierTypeStateIssuer
00770355MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Clearview Recovery Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1689847394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394031030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S 19TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016171",
            "telephone_number": "601-544-4641",
            "fax_number": "601-584-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGION XII COMM ON MENTAL HEALTH DBA PINE BELT MENTAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "MAYS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-544-4641"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770355",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.