| NPI | 1952879868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA LONG Owner, President 405-822-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2024-06-10 |