| NPI | 1225630494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MICHAEL President 405-464-1051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-12-23 |