| NPI | 1063808152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD JAY GAMBLE Mental Health Provider 405-522-0318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK V082812447) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |