| NPI | 1558468694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY A ROGERS Executive Director 662-234-7521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MS REG2-AGENCY) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-09-07 |