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Organization
REVITALIZING HOPE, LLC
Active
Organization
REVITALIZING HOPE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY LONG (PRESIDENT)
(405) 831-3202
Entity
Organization
Contact information
Practice address
6003 N ROBINSON AVE, SUITE 101, OKLAHOMA CITY, OK 73118-7425
(405) 831-3202
Mailing address
PO BOX 1250, GUTHRIE, OK 73044-1250
(405) 831-3202
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/10/2010
Last updated
10/12/2012
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