NPI | 1255142485 |
---|---|
Entity Type | Organization |
Authorized Contact | LASONYA C FORD-JACKSON Owner 870-275-3513 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2025-01-16 |
Last Update Date | 2025-01-16 |