| NPI | 1730203951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY QUINTILA RIDEAUX Program Assistant 405-425-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |