| NPI | 1740711233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE DAWSON Licensed Clinical Social Worker 228-861-8162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS C8074) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2017-03-25 |