| NPI | 1932379096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE BUTLER Administrator 601-732-8473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS 04970592) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |