| NPI | 1306905096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG HENDERSON Director 9189-582-0061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 261QM0801X) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-07-17 |