| NPI | 1023487139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA HAILES Administrator 601-410-5836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 251J00000X Nursing Care | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2023-10-23 |