Organization
INSTILLING HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MCCALLISTER L.P.C (OWNER)
(405) 556-0912
Entity
Organization
Contact information
Practice address
3130 NW 23RD ST, OKLAHOMA CITY, OK 73107-1902
(405) 556-0912
(405) 808-8856
Mailing address
3130 NW 23RD ST, OKLAHOMA CITY, OK 73107-1902
(405) 556-0912
(405) 808-8856
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
4840
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002424370
OKLAHOMA HEALTH CARE AUTHORITY
OK
Enumeration date
08/21/2012
Last updated
08/21/2012
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