| NPI | 1285716928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J BALTZ Center Director 601-364-1359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |