Organization · Type 2 NPI
Brenda Sue Mathis
Mental Illness Community Based Residential Treatment Facility · Broken Arrow, OK
NPI number
1215261086
Active
Practice location
4034 W Roanoke Pl
Broken Arrow, OK 74011-1327
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
| Psychiatric Residential Treatment Facility | 323P00000X | 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 1215261086
Brenda Sue Mathis's National Provider Identifier is 1215261086, issued on Sep 28, 2009. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Broken Arrow, OK. The record was last updated on Sep 28, 2009.