| NPI | 1124395868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DE'LICIA SHONTEZ BURRELL Rehabilitation Specialist 580-212-7335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 103k00000x) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |