| NPI | 1053489260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA HILLMAN Office Director 601-906-0879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2022-12-02 |