| NPI | 1225211402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEOTHA MONTGOMERY Owner 662-334-1650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: MS 59213) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2007-12-11 |