| NPI | 1891061636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO BETH FANCHER Division Director Reimbursement 405-573-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0002X Clinic/Center, Emergency Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2025-09-11 |