| NPI | 1457791832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE D. TUCKER Member 405-226-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 5437) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-28 |