Organization
IMMANUEL714
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH C WASHINGTON MS (CEO)
(405) 286-0383
Entity
Organization
Contact information
Practice address
713 NW 142ND ST, EDMOND, OK 73013-1924
(405) 286-0383
Mailing address
713 NW 142ND ST, EDMOND, OK 73013-1924
(405) 286-0383
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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