| NPI | 1164513495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA W GREENE Clinical Director 405-604-5344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: OK 014270185) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |