Organization
DRAGONFLY MENTAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DAWN MACKEY LCSW (OWNER/DIRECTOR)
(918) 281-5465
Entity
Organization
Contact information
Practice address
154 SOUTH COONROD AVE, MANNFORD, OK 74044-7404
(918) 865-4130
(918) 865-4136
Mailing address
PO BOX 1344, MANNFORD, OK 74044-1344
(918) 865-4130
(918) 865-4136
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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