| NPI | 1740951805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEKIA TAYLOR Owner/Manager 662-347-5997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2024-08-01 |