| NPI | 1033456355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDY SHUBIN Administration 405-208-9354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |