Organization
INNOVATIVE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BOURNE LPC (OWNER)
(479) 461-5275
Entity
Organization
Contact information
Practice address
2370 S KERR BLVD, SALLISAW, OK 74955-7031
(479) 461-5275
Mailing address
3308 S 54TH ST, FORT SMITH, AR 72903-4617
(479) 461-5275
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4216
OK
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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