Positive Changes Llc | |
301 Nw 63rd St Ste 650 Oklahoma City OK 73116-7915 | |
(405) 607-1717 | |
(405) 607-3332 |
Full Name | Positive Changes Llc |
---|---|
Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 301 Nw 63rd St Ste 650, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Laura C. Balliett-box (CFO) |
Authorized Official Contact | 4056071717 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Positive Changes Llc 744 Se 25th St Oklahoma City OK 73129-4843 Ph: (405) 636-1463 | Positive Changes Llc 301 Nw 63rd St Ste 650 Oklahoma City OK 73116-7915 Ph: (405) 607-1717 |
NPI Number | 1891871489 |
---|---|
Provider Enumeration Date | 10/27/2006 |
Last Update Date | 04/05/2024 |
Certification Date | 04/05/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891871489 | NPI | - | NPPES |
200063170D | Medicaid | OK | |
422897 | Other | JCAHO | |
200063170F | Medicaid | OK | |
200063170A | Medicaid | OK | |
200063170E | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
283Q00000X | Psychiatric Hospital | (* (Not Available)) | Secondary |
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