| NPI | 1063607117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLA DEAN CROW Substance Abuse Counselor 405-964-2081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OK 98) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2008-04-20 |