| NPI | 1750914560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENA GANESAN CEO 405-627-9263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2024-08-23 |