NPI | 1104630862 |
---|---|
Entity Type | Organization |
Authorized Contact | KESHIA DUKES Owner/Clinician 662-307-9028 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2025-02-04 |
Last Update Date | 2025-02-04 |