Organization
LATINO COMMUNITY DEVELOPMENT AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA B. FENNELL MSW (PRESIDENT/CEO)
(405) 236-0701
Entity
Organization
Contact information
Practice address
420 SW 10TH ST, OKLAHOMA CITY, OK 73109-5610
(405) 236-0701
(405) 236-0773
Mailing address
420 SW 10TH ST, OKLAHOMA CITY, OK 73109-5610
(405) 236-0701
(405) 236-0773
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200075270
—
OK
Enumeration date
04/06/2010
Last updated
04/06/2010
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