| NPI | 1376669135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY DOSS Accts Rec/Billing Supervisor 662-323-9318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-07-29 |