NPI | 1043492770 |
---|---|
Entity Type | Organization |
Authorized Contact | KAYE RAY Chief Executive Officer 601-545-8700 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2007-12-05 |
Last Update Date | 2022-09-06 |