| NPI | 1255631610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE M PRATT Vice President 662-893-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2010-11-01 |