| NPI | 1699566000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MARLIN Business Manager 918-640-7122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-05-14 |