NPI | 1851751135 |
---|---|
Entity Type | Organization |
Authorized Contact | PHILLIP A BLACK Owner 918-605-8614 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2649) |
Enumeration Date | 2016-03-01 |
Last Update Date | 2016-03-01 |