| Convalesce | |
|
626 N Broadway St Moore OK 73160-4814 | |
| (405) 430-8917 | |
| Not Available |
| Full Name | Convalesce |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 626 N Broadway St, Moore, Oklahoma |
| Authorized Official Name and Position | Christiane Lange (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4054308917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Convalesce 626 N Broadway St Moore OK 73160-4814 Ph: () - | Convalesce 626 N Broadway St Moore OK 73160-4814 Ph: (405) 430-8917 |
| NPI Number | 1639524994 |
|---|---|
| Provider Enumeration Date | 04/25/2016 |
| Last Update Date | 04/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639524994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5734 (Oklahoma) | Primary |
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