| NPI | 1295393387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY COOPER Owner 918-605-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-11 |