| NPI | 1841659232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZIE JENKINS Psychiatric Nurse Practitioner 601-616-4275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: TN 20825) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |