Generation Community Impact Foundation
NPI #1902613490 in Midwest City, Oklahoma
Provider Information
- NPI Number
- 1902613490
- Entity Type
- Organization
- Organization Name
- Generation Community Impact Foundation
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Dec 17, 2024
- Last Updated
- Dec 18, 2024
Practice Location
- Address
- 6520 E RENO AVE STE D
- City
- Midwest City
- State
- Oklahoma
- ZIP Code
- 73110-2119
- Phone
- (405) 455-3008
Authorized Official
- Name
- ANATAYA RUCKER, APRN
- Title
- CEO
- Phone
- (405) 314-4451
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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