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 |