| NPI | 1003469743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MASSEY Executive Director 601-927-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2020-08-03 |