| NPI | 1164684957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA BUNDY Administrator 918-658-3656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: OK NH4004-4004) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |