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General NPI Number Information
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NPI Number | 1528361458
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Entity Type | Organization
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Legal Business Name | PROMISES INC.
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 424 NW 143RD ST
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City | EDMOND
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State | OK
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Zip | 73013-2437
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Country | US
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Telephone | 405-706-8090
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Fax | 405-748-5244
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Provider Business Mailing Address
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Address Line | 505 NE 46TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105-3314
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Country | US
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Telephone | 405-270-0005
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DARNELL REX
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Credential |
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Telephone | 405-270-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OK
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