| NPI | 1376022202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE WEEDEN Manager 601-955-2387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2018-08-10 |