| Pennington Creek Lifehouse | |
|
130 N Greenwood Ave Ste 200 Tulsa OK 74120-1409 | |
| (539) 664-4621 | |
| Not Available |
| Full Name | Pennington Creek Lifehouse |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 130 N Greenwood Ave Ste 200, Tulsa, Oklahoma |
| Authorized Official Name and Position | Oreon Odell Leblanc (REHABILITATION SPECIALIST) |
| Authorized Official Contact | 9188151371 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennington Creek Lifehouse 11644 N 103rd East Ave Collinsville OK 74021-4821 Ph: (918) 815-1371 | Pennington Creek Lifehouse 130 N Greenwood Ave Ste 200 Tulsa OK 74120-1409 Ph: (539) 664-4621 |
| NPI Number | 1326393554 |
|---|---|
| Provider Enumeration Date | 07/13/2012 |
| Last Update Date | 07/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326393554 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Oklahoma) | Primary |
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