AUTOSPA-HEALTHY YOUTH CENTER; NPI #1063957751

Contact Information

AUTOSPA-HEALTHY YOUTH CENTER

1202 DESOTO AVE
SUITE A
CLARKSDALE, MS 38614

Phone: 662-209-1202
Fax: 662-483-1627
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Family	363LF0000X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for AUTOSPA-HEALTHY YOUTH CENTER

NPI Number	`1063957751`
LBN Legal business name	AUTOSPA-HEALTHY YOUTH CENTER
Authorized official	GREGORY HOSKINS - (PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/04/2017
Last updated	01/04/2017 - About 9 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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