MEDICARE: DAY BY DAY COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1700152402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAY BY DAY COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	1205 S AIR DEPOT BLVD # 122
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-4807
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 S AIR DEPOT BLVD # 122
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-4807
Country	:	US
Telephone Number	:	405-205-3742
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANDA LOWERY
Credential	:
Telephone Number	:	405-205-3742

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	03/27/2012

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