| NPI | 1225647746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LEIGH LEEP Amin 918-316-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2024-02-15 |