| NPI | 1093891681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON MOORE Director 405-789-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: OK NH5574) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |