Ellisville State School
Ellisville State School provides Technician services in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.
- Licensed in
- MS
- In the registry since
- 2006
Practice location Address checks out
1101 Highway 11 SEllisville, MS 39437-4443 Not confirmed with CMS for 18 years — call before visiting
Phone: (601) 477-9384
Fax: (601) 477-5700
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Technician (primary) | Taxonomy 374700000X · Licence ESS-BMR (MS) |
|---|
Record details
| NPI number | 1164582821 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Suzie Lassiter — Director Of Facility · (601) 477-9384 |
| Other names | Epsdt |
| NPI enumerated | December 11, 2006 |
| Last updated in NPPES | June 17, 2008 |
| Mailing address | 1101 Highway 11 S, Ellisville, MS 39437-4443 |