| NPI | 1821537259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY JORDAN Owner 601-214-1951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2017-02-17 |