| NPI | 1184950222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYNGI MONTGOMERY Owner 918-852-9644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 4100) |
| Enumeration Date | 2009-10-25 |
| Last Update Date | 2009-10-25 |