Family Transitions Llc | |
5005 N Pennsylvania Ave Suite 103 Oklahoma City OK 73112-8886 | |
(405) 753-4269 | |
(405) 753-4270 |
Full Name | Family Transitions Llc |
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Speciality | Clinic/Center |
Location | 5005 N Pennsylvania Ave, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Michael G Braun (AGENCY DIRECTOR) |
Authorized Official Contact | 4057534269 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Transitions Llc 5005 N Pennsylvania Ave Suite 103 Oklahoma City OK 73112-8886 Ph: (405) 753-4269 | Family Transitions Llc 5005 N Pennsylvania Ave Suite 103 Oklahoma City OK 73112-8886 Ph: (405) 753-4269 |
NPI Number | 1639207202 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 01/25/2011 |
Medicare PECOS PAC ID | 8527355429 |
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Medicare Enrollment ID | O20160920002878 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639207202 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 200076090A (Oklahoma) | Primary |
Provider Name | Roberta Snow |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1215189980 PECOS PAC ID: 8921083692 Enrollment ID: I20110323000664 |
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