| NPI | 1205378429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS HOLLOWAY Superintendent 662-324-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS R870489) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2016-11-07 |