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2000 E 15th St Ste 450c Edmond OK 73013-6670 | |
| (405) 761-1740 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2000 E 15th St Ste 450c, Edmond, Oklahoma |
| Authorized Official Name and Position | Kyle Mcgraw (CEO) |
| Authorized Official Contact | 4057611740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2000 E 15th St Ste 450c Edmond OK 73013-6670 Ph: (405) 761-1740 | 2000 E 15th St Ste 450c Edmond OK 73013-6670 Ph: (405) 761-1740 |
| NPI Number | 1083439210 |
|---|---|
| Provider Enumeration Date | 11/21/2024 |
| Last Update Date | 12/11/2024 |
| Certification Date | 12/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083439210 | NPI | - | NPPES |
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