| NPI | 1780127845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM COOPER Human Resources 662-536-6542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2020-06-16 |