| NPI | 1508922675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES L. COLEMAN CEO 601-859-5213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2018-06-25 |