| NPI | 1164668596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS CHARLES FELLRATH CEO 405-751-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CPFC001072) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |