| NPI | 1376168500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GREENE CEO/President 601-499-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-07-28 |