| NPI | 1902247158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN GRUENBERG President/Counselor 405-596-0178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4803) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 797) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2013-07-16 |