| Sugar Sweet Rehabilitation Services | |
|
8425 Nw 107th St Oklahoma City OK 73162-4050 | |
| (405) 977-9671 | |
| Not Available |
| Full Name | Sugar Sweet Rehabilitation Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8425 Nw 107th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Elzetta Taylor-woody (OWNER) |
| Authorized Official Contact | 4059779671 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sugar Sweet Rehabilitation Services 8425 Nw 107th St Oklahoma City OK 73162-4050 Ph: (405) 977-9671 | Sugar Sweet Rehabilitation Services 8425 Nw 107th St Oklahoma City OK 73162-4050 Ph: (405) 977-9671 |
| NPI Number | 1831921303 |
|---|---|
| Provider Enumeration Date | 08/14/2024 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 4789124777 |
|---|---|
| Medicare Enrollment ID | O20240905000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831921303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| Provider Name | Elzetta Elizabeth Taylor-woody |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861833840 PECOS PAC ID: 5698215689 Enrollment ID: I20240905000235 |
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