| NPI | 1134704489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM BRADSHAW Board President 918-708-2015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| 251V00000X Voluntary or Charitable | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |