| NPI | 1952616039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BALDWIN Counselor 580-234-7581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |