| NPI | 1750719886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYLEE NANNELL GASKINS Self 918-272-5326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |