Organization
SHELTERED WORK ACTIVITY PROGRAM
Active
Other names
SWAP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD B BREEN PHD (CEO)
(918) 683-8162
Entity
Organization
Contact information
Practice address
210 E OKMULGEE ST, MUSKOGEE, OK 74403-5453
(918) 683-8162
(918) 687-5368
Mailing address
210 E OKMULGEE ST, MUSKOGEE, OK 74403-5453
(918) 683-8162
(918) 687-5368
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100682680A
—
OK
Enumeration date
08/23/2007
Last updated
07/31/2008
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