| NPI | 1497179428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASITY LAVINE Owner 405-562-4891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK 261QM801X) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2014-02-11 |