| NPI | 1548099765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAKITA LAVETT BEVERLY Nurse Practitioner/Owner 662-374-3209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-07-27 |
| Last Update Date | 2024-08-13 |