| NPI | 1073105334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONNA PHILLIPS Nurse Practitioner 601-498-8132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |