| NPI | 1104435288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA MASQUAT Owner 405-625-1665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-08-04 |