| NPI | 1407225071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT D PILGRIM Member 405-285-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: OK NH4206) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2024-08-29 |