| NPI | 1770886012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN WILLIAMS Adult Clinical Manger 662-349-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MS LPC 1510) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2010-12-08 |