Provider Demographics
NPI:1497027437
Name:FDBHS, LLC
Entity Type:Organization
Organization Name:FDBHS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RENINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORSHEE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:405-751-8640
Mailing Address - Street 1:11032 QUAIL CREEK RD
Mailing Address - Street 2:STE. 265
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6219
Mailing Address - Country:US
Mailing Address - Phone:405-751-8640
Mailing Address - Fax:405-302-2592
Practice Address - Street 1:11032 QUAIL CREEK RD
Practice Address - Street 2:STE. 265
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6219
Practice Address - Country:US
Practice Address - Phone:405-751-8640
Practice Address - Fax:405-302-2592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health