| NPI | 1700114253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIE FAYE HENDERSON Administrator 405-447-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: OK RC1401-1401) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2009-11-20 |