Organization
12&12 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WAYNETTA FAYE BRAWDY CM (CASEMANAGER)
(918) 664-4224
Entity
Organization
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 664-4224
(918) 663-0203
Mailing address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 664-4224
(918) 663-0203
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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