| NPI | 1043630676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY LORRAINE HEARNE Rehabilitation Counselor 405-642-5460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |