Healthcare Provider Details

I. General information

NPI: 1235054917
Provider Name (Legal Business Name): ASTRA OK BHE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9905 S PENNSYLVANIA AVE STE A
OKLAHOMA CITY OK
73159-6920
US

IV. Provider business mailing address

100 NE 5TH ST
OKLAHOMA CITY OK
73104-2228
US

V. Phone/Fax

Practice location:
  • Phone: 919-200-0240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EITAN ADAMS
Title or Position: MANAGER
Credential:
Phone: 919-200-0240