| NPI | 1003875394 |
|---|---|
| Doing Business As | ITTA BENA CLINIC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER DAWNE HOLMES CFO 662-459-2603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2018-05-07 |