| NPI | 1528436862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON RAMEY Interim Director 662-286-9883 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS REG4-AGENGY) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2018-03-17 |