Organization
CEDAR RIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA CHRISTINA PHILLIPS (CASE MANAGER)
(405) 605-5934
Entity
Organization
Contact information
Practice address
6501 NE 50TH ST, OKLAHOMA CITY, OK 73141-9118
(405) 605-6111
Mailing address
1250 N AIR DEPOT BLVD, APT. 111, MIDWEST CITY, OK 73110-3349
(405) 921-7322
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
283Q00000X
OK
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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