| NPI | 1881859338 |
|---|---|
| Doing Business As | P G MIDDLE SCHOOL SCHOOL BASE CLINIC |
| Entity Type | Organization |
| Authorized Contact | LADONNA DAVIS Chief Operating Officer 601-437-3050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2011-12-19 |