| NPI | 1780133827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDI FULTZ Clinical Director 918-280-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 3283) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |