| NPI | 1790273654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRETTA WASHINGTON CEO 601-597-7291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 22003783879) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |