OrganizationActive
Specialized Treatment Facility
NPI 1467637488 · Psychiatric Residential Treatment Facility · Gulfport, MS
Provider details
- NPI number
- 1467637488
- Entity type
- Organization
- Primary specialty
- Psychiatric Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Shannon Bush, Program Director(228) 328-6000
- License
- 981 (MS)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
14426 James Bond Rd
Gulfport, MS 39503-8311
Phone: (228) 328-6000
Fax: (228) 328-6035
Approximate (ZIP-level) locationGet directions
Mailing address
14426 James Bond Rd
Gulfport, MS 39503-8311
Registry dates
- Enumerated
- 2008-01-09
- Last updated
- 2019-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.