Provider Demographics
NPI:1215615455
Name:TF COMMUNITY MENTAL HEALTH LLC
Entity type:Organization
Organization Name:TF COMMUNITY MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-878-8040
Mailing Address - Street 1:1458 MONCURE MARBLE RD
Mailing Address - Street 2:
Mailing Address - City:TERRY
Mailing Address - State:MS
Mailing Address - Zip Code:39170-9605
Mailing Address - Country:US
Mailing Address - Phone:601-878-8040
Mailing Address - Fax:601-878-8034
Practice Address - Street 1:1458 MONCURE MARBLE RD
Practice Address - Street 2:
Practice Address - City:TERRY
Practice Address - State:MS
Practice Address - Zip Code:39170-9605
Practice Address - Country:US
Practice Address - Phone:601-878-8040
Practice Address - Fax:601-878-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)