| NPI | 1639592900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT THOMPSON CEO 918-289-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2024-06-26 |