Organization
ADDICTION & BEHAVIORAL HEALTH CENTER, INC
Active
Organization
ADDICTION & BEHAVIORAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP LANE BENNETT LPC (COUNSELOR)
(405) 712-0514
Entity
Organization
Contact information
Practice address
124 S BROADWAY AVE, SUITE 200, ADA, OK 74820-5820
(580) 332-3001
Mailing address
124 S BROADWAY AVE, ADA, OK 74820-5820
(580) 332-3001
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2291
OK
Other
Enumeration date
10/06/2014
Last updated
10/08/2014
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