| NPI | 1548005655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRICA ROBERTS Owner 918-813-8299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 261Q00000X Clinic/Center | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-06-29 |
| Last Update Date | 2026-01-14 |