| NPI | 1699980623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNELLE BRUMMEL Credentialing Specialist 405-858-2733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2547) |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2020-08-22 |