| NPI | 1366568602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAE ANN SHEPHERD Clinical Program Director 918-587-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2641) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |