| NPI | 1013014695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA RUTH MACK Certified Nurse Practitioner 601-362-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 281P00000X Chronic Disease Hospital (Licence: MS R725005) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2020-08-22 |