| NPI | 1013781509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYVETTA RENEE MICKELL CEO/Owner 601-807-4715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 174200000X Meals | |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |