| NPI | 1003949439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLYN DAWN WELDON GARY Executive Director 580-226-1838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2024-07-30 |