NPI 1114321486

Cedric Glenn

Practitioner Mental Illness Community Based Residential Treatment Facility Tulsa, OK

Practice location

Address: 1721 E 72nd St 1803, Tulsa, OK 74136-5372
Phone: (813) 388-3773

Registered specialties (2)

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Oklahoma →

Substance Abuse Rehabilitation Facility

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Oklahoma →

Registry record

NPI: 1114321486
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Oct 2014
Record last updated: 15 Oct 2014

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.