OrganizationActive
Imagine, LLC
NPI 1902052962 · Mental Health Clinic/Center (Including Community Mental Health Center) · Jackson, MS
Provider details
- NPI number
- 1902052962
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Baxter Hogue, President(601) 259-4081
- License
- 1093 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Behavioral Health & Social Service Providers
Practice location
1920 Dunbarton Dr
Jackson, MS 39216-5001
Phone: (601) 982-5376
Fax: (601) 982-5377
Approximate (ZIP-level) locationGet directions
Mailing address
1920 Dunbarton Dr
Jackson, MS 39216-5001
Registry dates
- Enumerated
- 2008-08-11
- Last updated
- 2024-11-05
- Certified
- 2024-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.