| NPI | 1194560763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA A SLAGLE Provider Payer Contracting Spec 918-600-3729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-26 |