| NPI | 1922888148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY MATTHEWS Manager 228-594-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-10-04 |