| NPI | 1528300050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN JENKINS Chief Clinical Services Officer 918-991-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2018-11-12 |