| NPI | 1467080432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA GUENTHER Owner/Manager 918-289-6765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2020-03-27 |