Organization
GENERATION COMMUNITY IMPACT FOUNDATION
Active
Other names
Onyx Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANATAYA RUCKER APRN (CEO)
(405) 314-4451
Entity
Organization
Contact information
Practice address
6520 E RENO AVE STE D, MIDWEST CITY, OK 73110-2119
(405) 455-3008
(405) 393-6329
Mailing address
PO BOX 52, SPENCER, OK 73084-0052
(405) 455-3008
(405) 393-6329
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/18/2024
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