Provider Demographics
NPI:1386356806
Name:GOLDEN TRIANGLE HEALING PLACE INC.
Entity type:Organization
Organization Name:GOLDEN TRIANGLE HEALING PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANAE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S, NCC
Authorized Official - Phone:662-435-0670
Mailing Address - Street 1:2345 HIGHWAY 47
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-4158
Mailing Address - Country:US
Mailing Address - Phone:479-430-1513
Mailing Address - Fax:
Practice Address - Street 1:1014 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2211
Practice Address - Country:US
Practice Address - Phone:662-435-0670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)