| NPI | 1467850875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN RANKIN Administrator 918-647-6297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-17 |