Provider Demographics
NPI:1649040627
Name:SOUTHAVEN HEARING HEALTH CENTER LLP
Entity type:Organization
Organization Name:SOUTHAVEN HEARING HEALTH CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER / AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, PHD
Authorized Official - Phone:662-510-8247
Mailing Address - Street 1:5699 GETWELL RD BLDG H1
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-7311
Mailing Address - Country:US
Mailing Address - Phone:662-510-8247
Mailing Address - Fax:662-510-7412
Practice Address - Street 1:5699 GETWELL RD BLDG H1
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-7311
Practice Address - Country:US
Practice Address - Phone:662-510-8247
Practice Address - Fax:662-510-7412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty