| NPI | 1780425231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA HOWARD Owner 918-810-9272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2024-06-06 |