| NPI | 1699559740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENA CLARDY CEO 662-640-4595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2025-06-09 |