REGION XII COMM ON MENTAL HEALTH DBA PINE BELT MENTAL HEALTHCARE (NPI# 1689847394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689847394 |
| Entity Type | Organization |
| Organization Name | REGION XII COMM ON MENTAL HEALTH DBA PINE BELT MENTAL HEALTHCARE |
| Practice Address |
103 S 19th Ave Hattiesburg MS 39401-6171 |
| Mailing Address |
Po Box 1030 Hattiesburg MS 39403-1030 |
| Practice Telephone | 6015444641 |
| Practice Fax Number | 6015844053 |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |
| Authorized Official Name | JANET MAYS (CFO) |
| Authorized Official Telephone | 6015444641 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00770355 | 05 |
| Street Address |
103 S 19TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-6171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982610572 | Region 12 Commission On Mental Health & Retardation Pine Belt Men | Clinic/Center | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2006-08-01 |
| 1780199935 | Christine Boehmer | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-12-11 |
| 1679084024 | Donald Allan Dearman | Nurse Practitioner | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-10-12 |
| 1750808176 | Jason Courtney | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-08-25 |
| 1780101105 | Raymond Wooten | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-08-25 |
| 1073039830 | Jessica Owens | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-08-14 |
| 1275057457 | Shalaunda Brown | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-31 |
| 1144744327 | Chyra Dixon | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-31 |
| 1376066910 | Pamela Griffith | Counselor | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-25 |
| 1912420720 | Katelin Holmes | Social Worker | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2017-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609410562 | O'keefe Educational Media | Day Training, Developmentally Disabled Services | 700 Pass Rd, Gulfport, MS 39501-6443 | 2019-11-04 |
| 1033684766 | Wish Health Services | Day Training, Developmentally Disabled Services | 1520 29th Ave Ste 16, Gulfport, MS 39501-2843 | 2018-10-09 |
| 1215463203 | Delta Care Hope Foundation | Day Training, Developmentally Disabled Services | 408 Highway 82 W, Indianola, MS 38751-2031 | 2017-05-11 |
| 1235679523 | Doris C. Bridges | Day Training, Developmentally Disabled Services | 3928 Allen Dr, Jackson, MS 39212-5379 | 2017-03-06 |
| 1366995110 | Senior Services, LLC | Day Training, Developmentally Disabled Services | 21 Northtown Dr, Jackson, MS 39211-3016 | 2016-07-28 |
| 1225498595 | Sheila Parr | Day Training, Developmentally Disabled Services | 6870 Center St E, Horn Lake, MS 38637-1903 | 2016-03-01 |
| 1033574413 | New Beginnings Adult Daycare 2 LLC | Day Training, Developmentally Disabled Services | 235 69th Ave, Meridian, MS 39307-5671 | 2015-12-29 |
| 1891150074 | Rem Mississippi | Day Training, Developmentally Disabled Services | 250 Katherine Dr, Flowood, MS 39232-8801 | 2015-12-15 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1215305909 | Mississippi Christian Family Services Inc | Day Training, Developmentally Disabled Services | 117 Delta St, Rolling Fork, MS 39159-2266 | 2015-09-11 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on REGION XII COMM ON MENTAL HEALTH DBA PINE BELT MENTAL HEALTHCARE.
| 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.