| NPI | 1447854229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY M NDUNGU Lpc 918-408-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2020-11-23 |