NPI 1215261086
Brenda Sue Mathis
Practice location
- Address
- 4034 W Roanoke Pl, Broken Arrow, OK 74011-1327
- Phone
- (918) 698-7171
Authorised official
- Name
- Brenda Sue Mathis
- Title
- Owner
- Phone
- (918) 698-7171
Registered specialties (3)
Mental Illness Community Based Residential Treatment Facility
Primary
Psychiatric Residential Treatment Facility
Substance Abuse Rehabilitation Facility
Registry record
- NPI
- 1215261086
- Entity type
- Organization
- NPI issued
- 28 Sep 2009
- Record last updated
- 28 Sep 2009
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.