| NPI | 1083349203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI KIRBY Director 580-481-8760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-07-25 |