| NPI | 1093410243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENA CLARDY CEO 662-660-4186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2025-01-31 |