| NPI | 1265590616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG JOHNSON Owner 405-527-1785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2025-05-20 |