| NPI | 1699987115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMERO KEITH MIDGETT Medical Doctor Ob Gyn 662-536-1646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TN x) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2022-07-21 |