| NPI | 1821636358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ARMSTRONG Billing Manager 918-533-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2023-06-07 |