| NPI | 1497585889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RELINDIS KOTKIONGAH TITA Owner 405-501-7869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2025-09-19 |