| NPI | 1245581594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ARLANDRUS FORD CEO/Owner 405-605-4249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2021-05-13 |