| NPI | 1851730121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH DICKSON TAYLOR Outpatient Lcsw 601-362-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: MS C6323) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2013-06-20 |