| NPI | 1194077073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHA WILSON Supervisor 405-522-6853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2747) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |