Provider Demographics
NPI: | 1801396924 |
---|---|
Name: | HIGHER PURPOSE COUNSELING CENTER LLC |
Entity Type: | Organization |
Organization Name: | HIGHER PURPOSE COUNSELING CENTER LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BRADLEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 405-812-1514 |
Mailing Address - Street 1: | 6444 NW EXPRESSWAY STE 425D |
Mailing Address - Street 2: | |
Mailing Address - City: | OKLAHOMA CITY |
Mailing Address - State: | OK |
Mailing Address - Zip Code: | 73132-8125 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 405-812-1514 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6444 NW EXPRESSWAY STE 425D |
Practice Address - Street 2: | |
Practice Address - City: | OKLAHOMA CITY |
Practice Address - State: | OK |
Practice Address - Zip Code: | 73132-8125 |
Practice Address - Country: | US |
Practice Address - Phone: | 405-812-1514 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-02-15 |
Last Update Date: | 2018-06-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |