| NPI | 1194579474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESS JOSLIN Credentialing Manager 918-766-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist Nutrition, Education | |
| 133V00000X Dietitian, Registered | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 208D00000X General Practice | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2025-07-01 |