Restorer of Youth and Families LLC

NPI #1063036424 in Tulsa, Oklahoma

Provider Information

NPI Number
1063036424
Entity Type
Organization
Organization Name
Restorer of Youth and Families LLC
Subpart
Yes (part of a larger organization)
Parent Organization
RESTORER OF YOUTH AND FAMILIES LLC
Primary Specialty
Clinic/Center - Community Health
Enumeration Date
Jun 2, 2020
Last Updated
Jun 2, 2020

Practice Location

Address
1831 E 71ST ST
City
Tulsa
ZIP Code
74136-3922
Phone
(918) 852-4695

Authorized Official

Name
DR. MICHAEL RUSSELL BAINES
Title
ADMIN
Phone
(918) 852-4695

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Community HealthCommunity Health

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