| NPI | 1518145408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY A ROGERS Executive Director 662-234-7521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MS REG2-DSA-PVS-COMRS-1) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2017-09-07 |