| NPI | 1205354974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA LISA PETERSON Executive Director 601-442-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251S00000X (Licence: MS 1112895) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2022-07-21 |