| NPI | 1104030402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MEREDITH Executive Director 580-212-0625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-03-28 |