| NPI | 1932665841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETRINA HOLLOWAY Director 918-872-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2023-09-06 |