NPI | 1730784893 |
---|---|
Entity Type | Organization |
Authorized Contact | CHET ALLEN THARPE Physician Owner 601-559-6188 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2020-12-04 |
Last Update Date | 2020-12-04 |