| NPI | 1881485571 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHAVEN ABNEY SMITH Therapist 601-624-3069  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health | 
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2025-05-13 | 
| Last Update Date | 2025-05-13 |