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General NPI Number Information
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NPI Number | 1184403156
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Entity Type | Organization
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Legal Business Name | APOLLO BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 1111 MAGNOLIA CT STE 205
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City | MOORE
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State | OK
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Zip | 73160-1391
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Country | US
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Telephone | 405-449-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 MAGNOLIA CT STE 205
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City | MOORE
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State | OK
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Zip | 73160-1391
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Country | US
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Telephone | 405-449-5519
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Fax |
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Authorized Official
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Title or Position | TREATMENT DIRECTOR
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Name | ASHLEY MAGANA
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Credential |
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Telephone | 405-856-6966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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