| NPI | 1396288361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE THOMPSON Medical Director 662-536-6542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2020-06-16 |