| NPI | 1831627405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY A PHILLIPS Owner/CEO 662-687-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 2058) |
| 1041C0700X Social Worker, Clinical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-07-21 |