| NPI | 1225278716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY PALMER Administrator 662-332-8848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MS 16335) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2014-09-11 |