National Provider Identifier Database

WEST MISSISSIPPI BEHAVIORAL SERVICE LLC
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

WEST MISSISSIPPI BEHAVIORAL SERVICE, LLC
3201 WISCONSIN AVE
VICKSBURG, MS39180-5350
Phone: 601-636-8006
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for WEST MISSISSIPPI BEHAVIORAL SERVICE, LLC

NPI Number 1952047391
Legal business name
LBN
WEST MISSISSIPPI BEHAVIORAL SERVICE, LLC
Authorized official DANIEL EDNEY - (OWNER / LLC MEMBER)
Entity Organization
Organization subpart No
Enumeration date 05/09/2022
Last updated 05/09/2022 - About 4 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.

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