Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellisville State School

Organization Clinic/Center · NPI 1568468080

Ellisville State School is a Clinic/Center in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2005.

Licensed in
MS
In the registry since
2005

Practice location Address checks out

1101 Hwy 11 S
Ellisville, MS 39437-4444
Phone: (601) 477-9384
Fax: (601) 477-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence C00638 (MS)

Record details

NPI number1568468080
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Suzie Lassiter — Director · (601) 477-9384
NPI enumeratedJune 21, 2005
Last updated in NPPESAugust 22, 2020
Mailing address1101 Hwy 11 S, Ellisville, MS 39437-4444

Other providers in Ellisville