| NPI | 1811179823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALT L PORTER Head Counselor 662-244-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS LPC#0050) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2008-06-16 |