| NPI | 1619012515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI LEE Executive Director 580-250-2640 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: OK 0005111) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: OK 0005111) |
| 261QM2500X Clinic/Center Medical Specialty | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2024-01-30 |