| NPI | 1720564933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN LEA LONG Owner/Operator/ Counselor 405-863-2602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1213) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |