| NPI | 1710012398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA C LESLIE Executive Director 334-279-7830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-03-13 |