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Ellisville State School — NPI 1164582821, Ellisville, MS | NPI Central

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NPI 1164582821

OrganizationActive

Ellisville State School

NPI 1164582821 · Technician · Ellisville, MS

Provider details

NPI number: 1164582821
Entity type: Organization
Primary specialty: TechnicianNursing Service Related Providers
Authorized official: Suzie Lassiter, Director of Facility
License: ESS-BMR (MS)

Practice location

1101 Highway 11 S

Ellisville, MS 39437-4443

Phone: (601) 477-9384

Fax: (601) 477-5700

More MS providers

Mailing address

1101 Highway 11 S

Ellisville, MS 39437-4443

Registry dates

Enumerated: 2006-12-11
Last updated: 2008-06-17

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.