| NPI | 1609550128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA EHRET Owner, Provider 601-596-8435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-10-11 |