| NPI | 1255661203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA RONEY MCRAE Director Of Clinical Services 228-575-7502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282E00000X (Licence: MS R-865422) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2010-01-13 |