| NPI | 1306114376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE CRUDUP Executive Director 601-371-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |