| NPI | 1972830933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL BLACK Diresctor Of Intensive Outpatient P 918-592-1622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2009-11-12 |