Divine Holistic Intervention Services LLC.
Clinic/Center, Mental Health (Including Community Mental Health Center) in Oklahoma City, OK. Organization (NPI-2).
NPI number1801366554
StatusActive
Last updated in NPPESNov 26, 2018
Details
- NPI
- 1801366554
- Entity type
- Organization (NPI-2)
- Legal business name
- Divine Holistic Intervention Services LLC.
- Organization subpart
- No
- Enumeration date
- Nov 26, 2018
- Last updated
- Nov 26, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
1330 N Classen Blvd Ste 310Oklahoma City, OK 73106-6834
Phone 405-821-8646
Mailing address
1330 N Classen Blvd Ste 310Oklahoma City, OK 73106-6834
Phone 405-821-8646
Authorized official
Henrietta Ngozi Evbuomwan
Director
4058218646
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