| NPI | 1659877355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY RANEA FOWLER Targeted Mental Health Case Manager 662-567-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2018-04-02 |