| NPI | 1902060825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI SQUYRES Social Work Supervisor 228-523-5833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: MS C6007) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |