| NPI | 1336906478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALEY BENSON Chief Executive Officer 228-215-0255 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2024-03-05 |
| Last Update Date | 2024-03-05 |