| NPI | 1922440171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA RILEY Crs 918-378-0359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |