Organization
COMMUNITY IMPACT YOUTH & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LARRENDA DEANEISHA PATTERSON MS, LADCU/S (THERAPIST)
(405) 863-5724
Entity
Organization
Contact information
Practice address
4209 NW 23RD ST., SUITE 100, OKLAHOMA CITY, OK 73107
(405) 863-5724
Mailing address
PO BOX 95751, OKLAHOMA CITY, OK 73143-5751
(405) 863-5724
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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