| NPI | 1598587453 |
|---|---|
| Former Legal Business Name | ELIZABETH MACY ROGERS |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MACY ROGERS Owner 228-860-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |