| Victory Grace Healing Mental Health Services, Llc | |
|
3171 S 129th East Ave # A2076 Tulsa OK 74134-3205 | |
| (918) 428-8713 | |
| Not Available |
| Full Name | Victory Grace Healing Mental Health Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3171 S 129th East Ave # A2076, Tulsa, Oklahoma |
| Authorized Official Name and Position | Channel Johnson (OWNER) |
| Authorized Official Contact | 9184288713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victory Grace Healing Mental Health Services, Llc 3171 S 129th East Ave # A2076 Tulsa OK 74134-3205 Ph: () - | Victory Grace Healing Mental Health Services, Llc 3171 S 129th East Ave # A2076 Tulsa OK 74134-3205 Ph: (918) 428-8713 |
| NPI Number | 1790504645 |
|---|---|
| Provider Enumeration Date | 10/08/2024 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790504645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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