| NPI | 1033501739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKIA CARTER Director 662-773-7066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 05521743) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2018-03-17 |