Organization
SHAMROCK BEHAVIORAL HEALTH SERVICES OF OKLAHOMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY DALE GROVES LPC, NCC (OWNER - THERAPIST)
(405) 464-3279
Entity
Organization
Contact information
Practice address
1600 E US HIGHWAY 66, SUITE #5, EL RENO, OK 73036-5787
(405) 464-3279
Mailing address
12309 NEWGATE DR, YUKON, OK 73099-6426
(405) 464-3279
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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