Distinctive Adolescent And Adult Guidance Counseling Services | |
2119 Riverwalk Dr # 218 Moore OK 73160-2700 | |
(405) 812-8623 | |
Not Available |
Full Name | Distinctive Adolescent And Adult Guidance Counseling Services |
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Speciality | Community/behavioral Health |
Location | 2119 Riverwalk Dr # 218, Moore, Oklahoma |
Authorized Official Name and Position | Deborah A Gray (OWNER) |
Authorized Official Contact | 4058128623 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Distinctive Adolescent And Adult Guidance Counseling Services 2119 Riverwalk Dr # 218 Moore OK 73160-2700 Ph: (405) 812-8623 | Distinctive Adolescent And Adult Guidance Counseling Services 2119 Riverwalk Dr # 218 Moore OK 73160-2700 Ph: (405) 812-8623 |
NPI Number | 1740517366 |
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Provider Enumeration Date | 11/04/2009 |
Last Update Date | 11/04/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740517366 | NPI | - | NPPES |
100735950 | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 4096 (Oklahoma) | Primary |
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