| NPI | 1366230427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA C MARK Executive Director 601-810-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |