NPI | 1659125193 |
---|---|
Entity Type | Organization |
Authorized Contact | JESS JOSLIN Credentialing Manager 918-766-8217 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2024-04-12 |
Last Update Date | 2024-04-14 |