| NPI | 1114351541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE JEAN TIPTON Owner/Operator 918-244-9876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-08-21 |