| NPI | 1831371210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK A BEVON, III Administrator 601-582-9157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311500000X Alzheimer Center (Dementia Center) (Licence: MS 1008) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |