| Organization Name: | THE JOURNEY RESOURCE CENTER |
| NPI Number: | 1033510391 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY ANN KELLY (COUNSELOR) |
| Mailing Address: | 114 E Bolton St Pontotoc |
| State: | MS US |
| Postal Code: | 388631506 |
| Phone Number: | 6607600115 |
| Fax Number: | 6624897298 |
| NPI Enumeration Date: | 09/05/2014 |
| NPI Last Update Date: | 09/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1923 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |