| NPI | 1063756591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKIDA P GOODEN CEO/Administrative Asst 662-313-7180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2014-04-17 |