| NPI | 1083300594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEONTRANESE TREVA TAYLOR Owner 601-587-4304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-04-20 |