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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELSIE NICOLE WINSTON (OWNER)
(405) 436-9517
Entity
Organization

Contact information

Practice address
7901 NE 10TH ST STE C111, MIDWEST CITY, OK 73110-3653
(405) 436-9517
Mailing address
7901 NE 10TH ST, MIDWEST CITY, OK 73110-3600
(405) 436-9517

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
03/29/2012
Last updated
03/14/2013
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