| NPI | 1407972045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY BENTLEY Executive Director 918-650-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |