| NPI | 1801828496 |
|---|---|
| Doing Business As | NORTHEAST MENTAL HEALTH-MENTA |
| Entity Type | Organization |
| Authorized Contact | RAQUEL ROSAMOND Executive Director 662-640-4595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-10-28 |