Organization
NORTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIAM MELISSA REYNOLDS B.A.,C.M. (CASE MANAGER)
(405) 272-0660
Entity
Organization
Contact information
Practice address
1140 N HUDSON AVE, OKLAHOMA CITY, OK 73103-3918
(405) 272-0660
Mailing address
2429 SW 80TH ST, OKLAHOMA CITY, OK 73159-4907
(405) 623-1184
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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