| NPI | 1801014550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L ROGERS Executive Assistant/Manager 918-463-2581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OK 651.00) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2013-12-19 |