| NPI | 1366851842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LOUISE SAMS Dietitian 928-338-3664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: OK 86008901) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2016-11-02 |