JACKSON VA MEDICAL CENTER - NPI 1285716928 - Substance Abuse Rehabilitation Facility in Jackson, MS

Q: What is the provider's specialty?

The provider's specialty is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

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About Jackson Va Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON VA MEDICAL CENTER (NPI 1285716928) is a healthcare organization registered as a substance abuse rehabilitation facility in Jackson, Mississippi and active in the NPI registry since October 2006. The organization lists Richard J Baltz, Center Director, as its authorized official.

NPPES Registry Identity

NPI1285716928

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NameJACKSON VA MEDICAL CENTER

Location Address1500 E WOODROW WILSON AVEJackson, MS 39216-5116

Mailing Address1500 E Woodrow Wilson AveJackson, MS 39216-5116 · (601) 362-4471 · Fax (601) 364-1298

Phone(601) 362-4471

Fax(601) 364-1298

Organization SubpartNo

Authorized OfficialRichard J BaltzCenter Director · (601) 364-1359

Enumeration DateOctober 20, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1285716928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

Definition

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.

1500 E WOODROW WILSON AVE, Jackson, MS 39216

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