| NPI | 1255977419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE ABSTON President 601-331-5908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 333600000X Pharmacy | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2024-01-11 |