| NPI | 1508108028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN LOEBNER Sole Mbr 918-607-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 0369) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |