| NPI | 1467637488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON Y BUSH Program Director 228-328-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MS 981) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2019-12-05 |