| NPI | 1518492362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN FIKES CEO 662-372-1691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2025-08-07 |