| NPI | 1609327329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA HAMMAKER Nurse Practitioner 601-942-1148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MS R875679) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |