| NPI | 1588915771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNNA D MACHTOLFF Owner 405-414-3891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 3181) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-09-27 |