| NPI | 1639973720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANCA BULLIE-THOMPSON Fnp C, Pmhnp Bc 601-345-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-01 |