National Provider Identifier Database

JACKSON VA MEDICAL CENTER
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

JACKSON VA MEDICAL CENTER
1500 E WOODROW WILSON AVE
JACKSON, MS39216-5116
Phone: 601-362-4471
Fax: 601-364-1298
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for JACKSON VA MEDICAL CENTER

NPI Number 1285716928
Legal business name
LBN
JACKSON VA MEDICAL CENTER
Authorized official RICHARD BALTZ - (CENTER DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 10/20/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for JACKSON VA MEDICAL CENTER

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