| Project Impact Oklahoma Llc | |
|
102 N 1st St Madill OK 73446-2202 | |
| (580) 677-9406 | |
| Not Available |
| Full Name | Project Impact Oklahoma Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 102 N 1st St, Madill, Oklahoma |
| Authorized Official Name and Position | Carol Sue Kimbro (VICE-PRESIDENT) |
| Authorized Official Contact | 5806779406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Impact Oklahoma Llc 102 N 1st St Madill OK 73446-2202 Ph: (580) 677-9406 | Project Impact Oklahoma Llc 102 N 1st St Madill OK 73446-2202 Ph: (580) 677-9406 |
| NPI Number | 1407154933 |
|---|---|
| Provider Enumeration Date | 03/08/2011 |
| Last Update Date | 07/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407154933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3839 (Oklahoma) | Primary |
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