NPI | 1902052962 |
---|---|
Entity Type | Organization |
Authorized Contact | BAXTER HUGH HOGUE President 601-259-4081 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MS 1093) |
Enumeration Date | 2008-08-11 |
Last Update Date | 2024-11-05 |