| NPI | 1932850229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOSHA LAIRD CEO 601-863-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 261QP2400X Clinic/Center, Prison Health |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2024-09-16 |