| NPI | 1114265246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMER SHANE FOLSTER Counselor 580-782-3337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK 607) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |