Organization · NPI-2

A Balanced Life Therapeutic Services

Community/Behavioral Health · Oklahoma City, OK

NPI number1356723290
StatusActive
Last updated in NPPESJun 27, 2015

Details

NPI
1356723290
Entity type
Organization (NPI-2)
Legal business name
A Balanced Life Therapeutic Services
Organization subpart
No
Enumeration date
Jun 27, 2015
Last updated
Jun 27, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes
251B00000X Case Management––

Practice location

10601 S Western Ave Ste 110
Oklahoma City, OK 73170-6215

Phone 405-551-0794

Mailing address

10601 S Western Ave Ste 110
Oklahoma City, OK 73170-6215

Authorized official

Candeeta Joy Oliver
Owner
4055510794

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