| NPI | 1437470242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSELITO A SMITH Owner 405-301-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: OK K850000382) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: OK K850000382) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: OK K850000382) | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: OK K850000382) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OK K850000382) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |