| NPI | 1740526185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY MAE HARRIS Case Manager Community Support Ser 662-562-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MS 251S00000X-Community) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2012-12-12 |