| NPI | 1356835060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HUERKAMP Therapist 601-506-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-10-05 |