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Organization
GROW WELL BEHAVIORAL HEALTH LLC
Active
Organization
GROW WELL BEHAVIORAL HEALTH LLC
Active
Parent organization
GROW WELL HEALTH LLC
Other names
Grow Well Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
GROW WELL HEALTH LLC
Authorized official
MR. MATTHEW CLARK (CHIEF EXECUTIVE OFFICER)
(918) 488-8002
Entity
Organization
Contact information
Practice address
5840 S MEMORIAL DR STE 212, TULSA, OK 74145-9081
(918) 488-8002
Mailing address
5840 S MEMORIAL DR STE 212, TULSA, OK 74145-9081
(918) 644-1858
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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