FULL LIFE FAMILY RESOURCE CENTER LLC NPI 1215353016

NPI Information

  • NPI: 1215353016
  • Provider Name: FULL LIFE FAMILY RESOURCE CENTER LLC
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Address: 205 MAIN ST
    BROKEN BOW, OK
    ZIP 74728
  • Phone: (580) 584-2478

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NPI Details

FULL LIFE FAMILY RESOURCE CENTER LLC is a community behavioral health in Broken Bow, OK. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. FULL LIFE FAMILY RESOURCE CENTER LLC NPI is 1215353016. The provider is registered as an organization entity type.

The provider's business location address is:

205 MAIN ST
BROKEN BOW, OK
ZIP 74728-975
Phone: (580) 584-2478
Fax: (580) 584-2478

The provider's authorized official is Glynis Daniel .
The authorized official title is President and has the following contact phone number (580) 584-2478.

The enumeration date for this NPI number is 3/17/2014 and was last updated on 3/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral Health3881OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1XXXXMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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