Provider Demographics
NPI:1619563780
Name:CAIRN WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:CAIRN WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SELENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-509-9194
Mailing Address - Street 1:26 E 9TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3911
Mailing Address - Country:US
Mailing Address - Phone:405-509-9194
Mailing Address - Fax:
Practice Address - Street 1:26 E 9TH ST STE B
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3911
Practice Address - Country:US
Practice Address - Phone:405-509-9194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)