Organization
FOUNDATIONS BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE BALLARD MSW,CSW (EXECUTIVE DIRECTOR)
(918) 508-9696
Entity
Organization
Contact information
Practice address
16382 E HIGHWAY 20, CLAREMORE, OK 74019-3946
(918) 508-9696
Mailing address
PO BOX 3062, CLAREMORE, OK 74018-3062
(918) 508-9696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/14/2015
Last updated
06/14/2024
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