| NPI | 1528224110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE O'BRIEN Owner / Director 5802-340-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 3802) |
| Enumeration Date | 2008-08-02 |
| Last Update Date | 2008-08-02 |