| NPI | 1124345590 |
|---|---|
| Other Name | CEDAR RIDGE ADOLESCENT RTC |
| Entity Type | Organization |
| Authorized Contact | JOHN A. HOLTER CEO 4056-056-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: OK k8500000368) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2010-04-26 |