| Spring Eternal | |
|
310 Ne 28th St Ste. 204 Oklahoma City OK 73105-2806 | |
| (405) 601-4565 | |
| (405) 601-4579 |
| Full Name | Spring Eternal |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 310 Ne 28th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Mariechia L Palmer (OWNER) |
| Authorized Official Contact | 4056231976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Eternal 310 Ne 28th St Ste. 204 Oklahoma City OK 73105-2806 Ph: (405) 601-4565 | Spring Eternal 310 Ne 28th St Ste. 204 Oklahoma City OK 73105-2806 Ph: (405) 601-4565 |
| NPI Number | 1811238868 |
|---|---|
| Provider Enumeration Date | 03/14/2013 |
| Last Update Date | 03/01/2024 |
| Certification Date | 03/01/2024 |
| Medicare PECOS PAC ID | 7517303365 |
|---|---|
| Medicare Enrollment ID | O20240314003077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811238868 | NPI | - | NPPES |
| 200491750A | Medicaid | OK | |
| 200491750B | Medicaid | OK |
| Provider Name | Mariechia Lashawn Palmer |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568792547 PECOS PAC ID: 1850737669 Enrollment ID: I20240314001520 |
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