| NPI | 1336681584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM COOPER Human Resources 662-536-6542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2020-06-30 |