Ellisville State School
Ellisville State School is a Health Maintenance Organization 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
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
| Health Maintenance Organization (primary) | Taxonomy 302R00000X · Licence 233 (MS) |
|---|
Record details
| NPI number | 1720181191 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Pam Young — Accounting Auditor 1 · (601) 477-5606 |
| Other names | Clover Circle Icf/Mr |
| NPI enumerated | September 7, 2006 |
| Last updated in NPPES | June 12, 2008 |
| Mailing address | 1101 Highway 11 S, Ellisville, MS 39437-4443 |