| NPI | 1780922286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB TYLER HAHN Agency Director 918-815-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 4862) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-01-18 |