COPAC ADDICTION SERVICES (NPI# 1073679817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073679817 |
| Entity Type | Organization |
| Organization Name | COPAC ADDICTION SERVICES |
| Practice Address |
3949 Highway 43 N Brandon MS 39047-7240 |
| Mailing Address |
5857 Kristen Dr Jackson MS 39211-2831 |
| Practice Telephone | 6018292500 |
| Practice Fax Number | 6018294278 |
| Mailing Telephone | 6019560303 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2010-06-25 |
| Authorized Official Name | WANDA NEWTON JOHNSON (FAMILY NURSE PRACTITIONER) |
| Authorized Official Telephone | 6018292500 |
| Authorized Official Credential | CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | R586986 | MS | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | DEA NUMBER | MJ1222063 | 01 |
| Street Address |
3949 HIGHWAY 43 N |
| City | BRANDON |
| State | MS |
| Zip Code | 39047-7240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730289802 | Lloyd James Gordon IIi | Internal Medicine | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-09-25 |
| 1609409762 | Defining Wellness Centers Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2020-02-18 |
| 1306323720 | Pb Mississippi Health Services, LLC | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2018-07-27 |
| 1508386582 | Elements Medical Group of Mississippi Inc | Psychiatry & Neurology | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2017-06-21 |
| 1699175042 | Southeast Behavioral Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2014-09-03 |
| 1235270885 | Copac, Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2007-02-08 |
| 1376609768 | Susan Henry Taylor | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-12-29 |
| 1801997127 | Karen Holloway | Psychiatry & Neurology | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1801930532 | Susanne Reynolds Moore | Dentist | 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 | 2007-02-16 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| Find all providers in zip 39047 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285951764 | Rehab After Work of Florida, LLC | Substance Abuse Rehabilitation Facility | 773 W Lumsden Rd, Brandon, FL 33511-6261 | 2010-04-23 |
| 1962542423 | Phoenix Programs of Florida, Inc. | Substance Abuse Rehabilitation Facility | 510 Vonderburg Dr., Suite 301, Brandon, FL 33511-6072 | 2007-02-07 |
| 1609409762 | Defining Wellness Centers Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2020-02-18 |
| 1306323720 | Pb Mississippi Health Services, LLC | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2018-07-27 |
| 1699175042 | Southeast Behavioral Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2014-09-03 |
| 1235270885 | Copac, Inc. | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2007-02-08 |
| 1376609768 | Susan Henry Taylor | Substance Abuse Rehabilitation Facility | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1861047250 | Defining Wellness Centers Inc. | Substance Abuse Rehabilitation Facility | 630 Lakeland East Dr Ste A, Flowood, MS 39232-9565 | 2019-08-03 |
| 1093284598 | Safe Harbor Recovery and Counseling LLC | Substance Abuse Rehabilitation Facility | 123 Westover Dr, Hattisburg, MS 39402-1329 | 2018-11-14 |
| 1164948196 | Extra Mile Recovery | Substance Abuse Rehabilitation Facility | 720 Oak Grove Rd, Mantachie, MS 38855-8469 | 2017-08-22 |
| 1891149738 | Stonewater Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 38 County Road 362, Oxford, MS 38655-8514 | 2016-04-18 |
| 1386042471 | Recovery House, Inc. | Substance Abuse Rehabilitation Facility | 770 Golding Road, Columbus, MS 39704-2590 | 2014-12-05 |
| 1487067237 | Addiction Campuses of Mississippi, LLC | Substance Abuse Rehabilitation Facility | 7185 Swinnea Rd, Southaven, MS 38671-6003 | 2014-06-10 |
| 1518206440 | Alcohol Services Center, Inc. | Substance Abuse Rehabilitation Facility | 950 N West St, Jackson, MS 39202-2566 | 2013-02-13 |
| 1023373586 | Clever Recovery | Substance Abuse Rehabilitation Facility | 185 Foxtrail Rd, Picayune, MS 39466-9027 | 2012-07-11 |
| 1669603593 | Harbor Houses of Jackson, Inc. | Substance Abuse Rehabilitation Facility | 5354 I 55 S, Jackson, MS 39272-9119 | 2009-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.