| NPI | 1043711161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIA SIDDIQUI Owner/Manager 601-880-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TX 78339) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |