| NPI | 1699366542 |
|---|---|
| Doing Business As | PINE GROVE BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | JACOB CORNELIUS PARKER Physician Assistant Student 601-545-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 174200000X | |
| 177F00000X Lodging | |
| 253J00000X Foster Care Agency | |
| 347D00000X Train | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2022-03-17 |