| NPI | 1710724026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DYE Owner 662-339-5165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |