Organization
AXG SERVICES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA X GOMEZ LADC-MH (PRESIDENT)
(405) 476-7561
Entity
Organization
Contact information
Practice address
305 NW 5TH ST, #1541, OKLAHOMA CITY, OK 73102-3016
(405) 476-7561
Mailing address
3321 S WESTERN AVE, SUITE 2, OKLAHOMA CITY, OK 73109-2408
(405) 476-7561
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
#334
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598848202
NPI NUMBER
OK
Enumeration date
08/03/2016
Last updated
08/03/2016
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