NPI | 1528445509 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER LEE ORMAN Owner 662-295-6015 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 11417301) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2023-10-17 |