| NPI | 1063558401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA HILLMAN Office Director 601-576-7886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-12-02 |