| NPI | 1023894904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEUDONNE BAKUNDA Owner 405-541-4825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2024-08-27 |