| NPI | 1366093791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WALTON CFO 601-483-4821 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |