| NPI | 1720326473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MARION Co Owner 601-956-4816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 12 00024395) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2022-07-21 |