| NPI | 1023318086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LORETO Director His / Business Office 662-873-5171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center, Emergency Care |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |