| NPI | 1225360084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SHOALS Clinical Director 405-272-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 082599603) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |