| NPI | 1184929697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI WATSON Credentialing Director 918-698-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 100734620) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2025-10-13 |