| NPI | 1043972144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN GEORGE STEPHENSON Executive Director 918-406-6682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |