| NPI | 1154106482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE A MIRJAFARI Physician Owner 918-406-2024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-08-25 |