| NPI | 1952898322 |
|---|---|
| Doing Business As | DBA |
| Entity Type | Organization |
| Authorized Contact | LATONYA HAILES Adminstrator 601-336-6114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-04-20 |