| NPI | 1326135104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE ALEXANDER SHEEHAN President 662-844-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MS 13618) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MS 13618) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-04-18 |