| NPI | 1265052369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DYER CEO 918-928-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2024-04-09 |