| NPI | 1770204364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHANG TRUONG Business Manager 405-532-3176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-09-12 |