Organization
I.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH COMBS SR. (CEO)
(405) 243-4252
Entity
Organization
Contact information
Practice address
1330 N CLASSEN BLVD, SUITE 313, OKLAHOMA CITY, OK 73106-6835
(405) 243-4252
Mailing address
1330 N CLASSEN BLVD, SUITE 313, OKLAHOMA CITY, OK 73106-6835
(405) 243-4252
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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