| NPI | 1790866861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE B HANEY Director 662-234-1476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 263) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |