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Organization
CREATING CHANGE
Active
Organization
CREATING CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINH THE NGUYEN (CEO)
(405) 474-6741
Entity
Organization
Contact information
Practice address
373 S YUKON PKWY, SUITE B, YUKON, OK 73099-4596
(405) 265-0986
Mailing address
373 S YUKON PKWY, SUITE B, YUKON, OK 73099-4596
(405) 265-0986
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/27/2016
Last updated
03/05/2016
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