NPIMap

Organization Active NPI

Mississippi Children'S Home Society

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Jackson, MS
National Provider Identifier
1710366273
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
MISSISSIPPI CHILDREN'S HOME SOCIETY
Practice address
1465 Lakeland Dr
Jackson, MS 39216-4719
Phone
(601) 352-7784
Fax
(601) 968-0021
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Dr. John D Damon, PH.D.
Title
Chief Executive Officer
Phone
(601) 352-7784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1465 Lakeland Dr
Jackson, MS 39216-4719

Mailing address

1465 Lakeland Dr
Jackson, MS 39216-4719
Phone (601) 352-7784

National Provider Directory

National Provider Directory
Tax ID family
Mississippi Children'S Home5 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.

Locations

1465 Lakeland Dr
Jackson, MS 39216
Phone (769) 777-1000

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1710366273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164719",
            "telephone_number": "601-352-7784",
            "fax_number": "601-968-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164719",
            "telephone_number": "601-352-7784",
            "fax_number": "601-968-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI CHILDREN'S HOME SOCIETY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "DAMON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "601-352-7784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.