| NPI | 1790261105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA FITZGERALD Executive Director & Licensed Thera 918-586-2039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK 1171) |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |