| NPI | 1043331499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT M. BLACK Executive Director 918-756-9411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 100734620L) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2019-10-15 |