| NPI | 1770756447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY A. ELLIS CEO 601-786-3475 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-06-20 |