| NPI | 1659158475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE FOMUNEN Director 405-361-8957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-09-14 |