| NPI | 1518341742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STOVALL Facility CEO 662-281-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MS AAC-PRS-01) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MS AAC-APH-01) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MS AAC-SO-01) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2021-08-25 |