| NPI | 1508036906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA VAN TRIEST-PEADEN President 580-436-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2965) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-12-22 |