| NPI | 1699020974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE J TISDALE CEO 918-497-8859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 3710) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2012-07-23 |