| NPI | 1083087985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA MARIE CLAYTON Chief Financial Officer 601-825-7280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2020-04-16 |