| NPI | 1952548059 |
|---|---|
| Other Name | ELLEN L MALONE SOLE MBR |
| Entity Type | Organization |
| Authorized Contact | ELLEN L MALONE Ower/Sole Mbr 228-497-8180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MS C2571) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2011-08-29 |