| NPI | 1629392774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA WHALEY Benefit Specialist 228-867-1348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MS 311) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |