| NPI | 1144533167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLA WEARY CHASE CEO 601-613-9971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 163wc1500x) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2010-07-19 |