| NPI | 1669769543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AALYSHA MICHELLE GONZALEZ President 918-740-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH9697) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-06-29 |