| NPI | 1720847726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE REZKALLA General Manager 918-704-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |