| NPI | 1609669365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MCNEIL Owner 601-376-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-08-08 |