| NPI | 1982494340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR ANDREA AL-ALAWNEH VP 918-812-0004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |