Organization
EAGLE RIDGE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JINA YOUNG MED, LADC, LPC (AREA COORDINATOR)
(405) 840-1359
Entity
Organization
Contact information
Practice address
601 NE 63RD ST, OKLAHOMA CITY, OK 73105-6407
(405) 840-1359
(405) 858-7015
Mailing address
601 NE 63RD ST, OKLAHOMA CITY, OK 73105-6407
(405) 840-1359
(405) 858-7015
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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