| NPI | 1083179329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERES CHANDLER Owner 662-295-7520 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363L00000X Nurse Practitioner | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2025-10-06 |