| Illuminated Direction | |
|
1903 Pass Rd Biloxi MS 39531-4119 | |
| (228) 209-9482 | |
| (601) 884-4466 |
| Full Name | Illuminated Direction |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1903 Pass Rd, Biloxi, Mississippi |
| Authorized Official Name and Position | Jonathan Lacewell (OWNER) |
| Authorized Official Contact | 9194506446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminated Direction 1903 Pass Rd Biloxi MS 39531-4119 Ph: (228) 209-9482 | Illuminated Direction 1903 Pass Rd Biloxi MS 39531-4119 Ph: (228) 209-9482 |
| NPI Number | 1679184980 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 01/08/2021 |
| Certification Date | 01/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679184980 | NPI | - | NPPES |
| 06307760 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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› Verified 5 days ago
Psycamore, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2620 Executive Pl, Biloxi, MS 39531 Phone: 228-385-7744 Fax: 601-939-5935 | |
Smb Counseling & Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1907 Pass Rd Ste D, Biloxi, MS 39531 Phone: 228-300-2425 Fax: 228-265-8117 | |
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