Revitalisong Hope LLC

NPI #1790003861 in Guthrie, Oklahoma

Provider Information

NPI Number: 1790003861
Entity Type: Organization
Organization Name: Revitalisong Hope LLC
Primary Specialty: Counselor - Professional
Enumeration Date: May 13, 2010
Last Updated: May 13, 2010

Practice Location

Address: 3321 IRON MOUND ROAD
City: Guthrie
State: Oklahoma
ZIP Code: 73044
Phone: (405) 831-3202

Authorized Official

Name: MR. BOBBY H. LONG
Title: PRESIDENT
Phone: (405) 831-3202

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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