| NPI | 1164279972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENA NGUYEN CEO 405-881-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-12-08 |