| NPI | 1073194163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK MARVIN TERRY CEO 601-942-7689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-04-20 |