| NPI | 1912238437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTRAND ANTOINE President 662-627-5317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 07427785) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2010-01-22 |