| NPI | 1720960289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE YOUNG President/Member 601-826-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2025-07-24 |