| NPI | 1720582307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYON MARK MOSHER CEO/Therapist 580-541-6416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2021-08-23 |