| NPI | 1750151387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY ANN BAINE Inpatient Lpn 918-207-9563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-01-04 |