| NPI | 1891920534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JOHN HENNE Counselor 405-321-0022 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 1629130166) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: OK 1629130166) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |