Individual provider · Type 1 NPI
Grace Mukombe
Emotionally Disturbed Childrens' Residential Treatment Facility · Norman, OK
Practice location
3400 Deskin Dr # 8295
Norman, OK 73069-8295
Fax (405) 701-8529
Mailing address
820 N Emerson St
Jenks, OK 74037-3828
Other practice locations
- 4436 NW 50th St, Oklahoma City, OK 73112-2212 · (405) 858-2700
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | None listed |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
About NPI 1992474969
Grace Mukombe's National Provider Identifier is 1992474969, issued on Sep 12, 2021. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Norman, OK. The record was last updated on Sep 12, 2021.