| NPI | 1619467735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRACLE MITCHELL CEO 601-826-9947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MS 1951) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: 6231) |
| 101YP2500X Counselor Professional (Licence: GA 009599) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |