CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI – NPI #1659041663
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

Health Care Provider Taxonomy Code for Internal Medicine

CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI is a provider located in SOUTHAVEN, MS. NPPES has assigned the NPI number 1659041663 to CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI on September 20, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RA0401X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 4 years ago on Aug 31, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI below.

NPI Profile for
CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI

NPI Number
1659041663
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CARE CLINIC FOR DRUG ADDICTION & MENTAL HEALTH IN NORTH MISSISSIPPI
Primary location
8829 CENTRE ST STE 200
SOUTHAVEN, MS 38671-2610
Phone: (662) 934-8671 Fax:
Mailing address
222 SOUTHLAKES DR
GRENADA, MS 38901-8499
Phone: (662) 934-8671 Fax:
Organization Subpart
No
Authorized Official
CEDRIC EDWARDS
MEDICAL DIRECTOR
Phone: (662) 934-8671
Updated
Certification Date
Jul 26, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RA0401X
- Internal Medicine / Addiction Medicine (Primary)
363LP0808X
- Nurse Practitioner / Psychiatric/Mental Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.