| NPI | 1023834017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE ALLISON CANTON Sole Member 405-471-4792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |