| NPI | 1639758162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE LEE PRICE Owner 918-708-1755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2023-02-16 |