| NPI | 1679652754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE A EZEM President/CEO 601-927-9839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2025-09-11 |