| NPI | 1184741100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT MACVAUGH Executive Director 662-335-5274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 16335) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |