NPI | 1366139040 |
---|---|
Entity Type | Organization |
Authorized Contact | TIERRA J PAGE Owner/President 405-209-2083 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2023-04-21 |
Last Update Date | 2024-09-13 |