Organization
PENNINGTON CREEK LIFEHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OREON ODELL LEBLANC COUNSELOR (REHABILITATION SPECIALIST)
(918) 815-1371
Entity
Organization
Contact information
Practice address
130 N GREENWOOD AVE STE 200, TULSA, OK 74120-1409
(539) 664-4621
Mailing address
11644 N 103RD EAST AVE, COLLINSVILLE, OK 74021-4821
(918) 815-1371
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OK
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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