| NPI | 1710613294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIDI ELLIS Executive Director 601-909-6294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-07-27 |