| NPI | 1447744669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGENIA PARKER Owner 601-497-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MS C9283) |
| Additional Taxonomies | 251S00000X (Licence: MS C9283) |
| 253Z00000X In Home Supportive Care (Licence: MS C9283) | |
| 261Q00000X Clinic/Center (Licence: MS C9283) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MS C9283) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-10-15 |