Individual provider · Type 1 NPI
Cedric Glenn
Mental Illness Community Based Residential Treatment Facility · Tulsa, OK
NPI number
1114321486
Active
Practice location
1721 E 72nd St, 1803
Tulsa, OK 74136-5372
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
| Substance Abuse Rehabilitation Facility | 324500000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
About NPI 1114321486
Cedric Glenn's National Provider Identifier is 1114321486, issued on Oct 15, 2014. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Tulsa, OK. The record was last updated on Oct 15, 2014.