| NPI | 1265814420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARION Owner 601-956-4816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MS M7826) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |