| NPI | 1346547908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FETIMA WELLINGTON Case Manager 580-355-0072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2612MQM0801X) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-10-25 |