| NPI | 1023373586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY MAXIMO Director 601-215-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MS 10662) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |