| NPI | 1902367618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY PHILLIPS Director Of Business Affairs 918-893-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |