| NPI | 1902101041 |
|---|---|
| Doing Business As | TRI LAKES BEHAVIORAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL HAVENS CEO 662-563-5611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: MS 13287) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2011-01-21 |