Organization
MENDING HEARTS LLC
Active
Organization
MENDING HEARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA KOMAHCHEET LADC, ICAADC (CO-OWNER/PRESIDENT)
(405) 213-3700
Entity
Organization
Contact information
Practice address
3212 SW 104TH TER, OKLAHOMA CITY, OK 73159-7800
(405) 821-7767
Mailing address
PO BOX 890900, OKLAHOMA CITY, OK 73189-0900
(405) 821-7767
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15525610002
OK
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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