| NPI | 1548894488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA ATKINSON Co Member 662-542-4928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2020-03-01 |