| NPI | 1649008509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY TULLOS Physician 601-529-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282E00000X |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-07-23 |