| NPI | 1255704755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY LYNN FITZGERALD Lead Counsleor 918-833-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 3870) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |