| NPI | 1194660936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY DAWN PANTHER Executive Director 918-896-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-04-20 |
| Last Update Date | 2026-04-20 |