| NPI | 1992865653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZIE LASSITER Director Of Facility 601-477-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: MS ESS-BMR) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |