| NPI | 1912436981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS M WRIGHT Managing Member Reconnect Outpatien 662-680-3148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2017-06-05 |