Organization
TIME WELLNESS OK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CANTO (COO)
(954) 654-2350
Entity
Organization
Contact information
Practice address
446724 E 390 RD, LANGLEY, OK 74350
(954) 654-2350
Mailing address
446724 E 390 RD, LANGLEY, OK 74350
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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