Organization
NEW START MHSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BREWER (ADMINISTRATIVE DIRECTOR)
(580) 514-6461
Entity
Organization
Contact information
Practice address
115 E MAIN ST, DAVIS, OK 73030-1905
(580) 514-6461
Mailing address
115 E MAIN ST, DAVIS, OK 73030-1905
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/08/2016
Last updated
02/17/2016
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