| NPI | 1336731983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LOBATO CEO 918-608-0380 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2023-01-09 |