| NPI | 1457768814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT WILSON Executive Director 601-362-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: MS 25C4PAS-5598) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2023-03-17 |