| NPI | 1194101352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STOVALL Facility CEO 662-281-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2021-08-25 |