NPI | 1063939247 |
---|---|
Entity Type | Organization |
Authorized Contact | DEREK SAMUEL THOMASON Counselor/Owner 501-551-1943 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK 6461) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OK 6461) |
261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OK 6461) | |
Enumeration Date | 2017-08-28 |
Last Update Date | 2022-07-21 |