| NPI | 1932925898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMESHIA BARNES Owner 601-433-7916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 174200000X Meals |
| 251S00000X Community/Behavioral Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |