| NPI | 1346997038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGI MAXWELL-DUVERGER Manager Credentialing 405-425-0428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-09-19 |