| NPI | 1649778739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MARIE HOLT Owner Administrator 228-623-5004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |