| NPI | 1538463468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE J RAYBURN Owner 405-202-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK OK3673) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-09-12 |