| NPI | 1134331846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE EUGENE ELLIS Director 405-557-1655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 251S00000X) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |