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General NPI Number Information
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NPI Number | 1962392266
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Entity Type | Organization
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Legal Business Name | MELY'S MEADOW INC.
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 5088 N 58TH WEST AVE
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City | TULSA
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State | OK
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Zip | 74126-4295
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Country | US
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Telephone | 918-800-3823
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Fax |
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Provider Business Mailing Address
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Address Line | 5088 N 58TH WEST AVE
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City | TULSA
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State | OK
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Zip | 74126-4295
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | ANTONY HORNBERGER
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Credential | CASE MANAGER, PRSS
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Telephone | 918-800-3823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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