| NPI | 1578383063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GRANT Owner 405-414-2826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-21 |