| NPI | 1316616626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY FLOWERS Manager 601-597-2362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 253Z00000X In Home Supportive Care | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 385H00000X Respite Care | |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2022-02-25 |