| NPI | 1306006515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON C JACKSON Director 662-332-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: MS 76c3pfa5142) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |