| NPI | 1043465040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LICHTE-MADAKASIRA Vice President 601-939-5993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2008-11-19 |