| NPI | 1063428761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE VAN Executive Director 601-824-0342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MS R081) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-06-27 |