| NPI | 1780852194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELILAH J. MOORE Clinical Director 601-982-8624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MS 00281) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |