| NPI | 1346665288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY DUANE GREEN Owner 580-277-5423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 4694) |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2014-03-01 |