| NPI | 1518410778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD KINNARD SMITH Owner/CEO 601-961-9723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MS 54398) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |