| 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 | 2023-10-18 |