| NPI | 1437171444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY DOSS Billing Supervisor 662-323-9318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-12-30 |