Organization
ETI - BEYOND THE BELL
Active
Organization
ETI - BEYOND THE BELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MYRON MAYBERRY (ASSISTANT DIRECTOR)
(405) 286-3900
Entity
Organization
Contact information
Practice address
245 W WILSHIRE BLVD, SUITE A, OKLAHOMA CITY, OK 73116-7754
(405) 286-3900
(405) 286-3911
Mailing address
245 W WILSHIRE BLVD, SUITE A, OKLAHOMA CITY, OK 73116-7754
(405) 286-3900
(405) 286-3911
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
200056310A
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200056310A
—
OK
Enumeration date
01/24/2007
Last updated
01/06/2012
Update your record
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