| NPI | 1255045324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN TAFT WRIGHT Chief Executive Officer 601-940-4195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 405300000X Prevention Professional |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2023-10-24 |