Cedric Glenn

NPI #1114321486 in Tulsa, Oklahoma

Provider Information

NPI Number: 1114321486
Entity Type: Individual
Name: Cedric Glenn
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Oct 15, 2014
Last Updated: Oct 15, 2014

Practice Location

Address: 1721 E 72ND ST
Address 2: 1803
City: Tulsa
State: Oklahoma
ZIP Code: 74136-5372
Phone: (813) 388-3773

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary
Substance Abuse Rehabilitation Facility	324500000X

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