NPI | 1336491349 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY SHANIQUE SHOALS Ex Clinical Director 405-601-4004 |
Organization Subpart ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Enumeration Date | 2012-10-15 |
Last Update Date | 2012-10-15 |