Organization
SHAPE OUR VILLAGE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICKA DAWN BRAGGS BCBA (CEO)
(619) 201-4747
Entity
Organization
Contact information
Practice address
410 WINDSOR RD, OKLAHOMA CITY, OK 73130-4943
(619) 201-4747
Mailing address
410 WINDSOR RD, OKLAHOMA CITY, OK 73130-4943
(619) 201-4747
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/09/2025
Last updated
12/09/2025
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