Organization
AVENUE OF HOPE ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE GANN (EXECUTIVE DIRECTOR)
(316) 347-4843
Entity
Organization
Contact information
Practice address
1815 N UNION ST, PONCA CITY, OK 74601-2440
(580) 686-0202
Mailing address
PO BOX 182, PONCA CITY, OK 74602-0182
(580) 686-0202
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
12/19/2024
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