Provider Demographics
NPI:1720960289
Name:ZOVIELLES FAMILY MEDICAL AND BEHAVIORAL HEALTH CARE, LLC
Entity type:Organization
Organization Name:ZOVIELLES FAMILY MEDICAL AND BEHAVIORAL HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:601-826-6200
Mailing Address - Street 1:PO BOX 833
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39130-0833
Mailing Address - Country:US
Mailing Address - Phone:601-826-6200
Mailing Address - Fax:
Practice Address - Street 1:7 LAKELAND CIR STE 500
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5022
Practice Address - Country:US
Practice Address - Phone:601-826-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)