Organization
GREENSIDE PRAIRIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM DANIEL LCSW (OWNER/OPERATOR)
(405) 265-6142
Entity
Organization
Contact information
Practice address
3104 NW 184TH ST, EDMOND, OK 73012-9650
(405) 265-6142
Mailing address
3104 NW 184TH ST, EDMOND, OK 73012-9650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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