| NPI | 1285947408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE'E BRETT Director 601-477-5595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2011-01-27 |