| NPI | 1861636029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RAE GLOVER Executive Director 580-351-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 2890) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |