| Second Wind Recovery And Support Services Pllc | |
|
3700 N Classen Blvd Suite C-55 Oklahoma City OK 73118-2872 | |
| (405) 605-0881 | |
| (405) 605-0879 |
| Full Name | Second Wind Recovery And Support Services Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3700 N Classen Blvd, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Jacquelyn D. Jordan (CEO/OWNER) |
| Authorized Official Contact | 4056050881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Wind Recovery And Support Services Pllc 3700 N Classen Blvd Suite C-55 Oklahoma City OK 73118-2872 Ph: (405) 605-0881 | Second Wind Recovery And Support Services Pllc 3700 N Classen Blvd Suite C-55 Oklahoma City OK 73118-2872 Ph: (405) 605-0881 |
| NPI Number | 1215357660 |
|---|---|
| Provider Enumeration Date | 04/24/2014 |
| Last Update Date | 04/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215357660 | NPI | - | NPPES |
| 1114263001 | Other | OK | NPI |
| 200530290A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 490 (Oklahoma) | Primary |
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