| Organization Name: | SHEPHEARST MEADOWS, LLC |
| NPI Number: | 1063603702 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA RENEA HEARST-TURNER (OWNER/CLINICAL DIRECTOR) |
| Mailing Address: | 513 Keywood Cir Flowood |
| State: | MS US |
| Postal Code: | 392323019 |
| Phone Number: | 6019331136 |
| Fax Number: | |
| NPI Enumeration Date: | 08/07/2007 |
| NPI Last Update Date: | 08/07/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 39649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |