| NPI | 1427311687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RAE MINTON Bhrs 620-404-8981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 25103TC1900X) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |