| NPI | 1063962215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY WAYNE GROVES Clinical Director 405-514-8628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2025-12-23 |