NPIMap

Organization Active NPI

Region IV Chemical Dependency Complex

  • Substance Abuse Rehabilitation Facility
  • Corinth, MS
National Provider Identifier
1982980850
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
REGION IV CHEMICAL DEPENDENCY COMPLEX
Practice address
401 New Hope Dr
Corinth, MS 38834-7458
Phone
(662) 287-7199
Fax
(662) 286-8908
NPI assigned
Oct 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Authorized official

Name
Mr. Charlie D Spearman Sr.
Title
Execuitive Director
Phone
(662) 286-9883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

401 New Hope Dr
Corinth, MS 38834-7458

Mailing address

PO Box 839
Corinth, MS 38835-0839
Phone (662) 286-9883

Other identifiers 1

IdentifierTypeStateIssuer
00018204MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Southaven Services31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 4

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": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1982980850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-286-9883",
            "fax_number": "662-286-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NEW HOPE DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388347458",
            "telephone_number": "662-287-7199",
            "fax_number": "662-286-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGION IV CHEMICAL DEPENDENCY COMPLEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUITIVE DIRECTOR",
        "authorized_official_telephone_number": "662-286-9883",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018204",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.