NPI | 1215341979 |
---|---|
Entity Type | Organization |
Authorized Contact | KIARA LASHAE JOHNSON Manager 601-918-6415 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2014-06-19 |
Last Update Date | 2014-06-19 |