NPI | 1184961153 |
---|---|
Other Name | PETAL PRIMARY SCHOOL |
Entity Type | Organization |
Authorized Contact | GEROLDEAN DYSE CEO 601-545-8700 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2013-01-11 |
Last Update Date | 2021-04-16 |