| Greenside Prairies Llc | |
|
3104 Nw 184th St Edmond OK 73012-9650 | |
| (405) 265-6142 | |
| Not Available |
| Full Name | Greenside Prairies Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3104 Nw 184th St, Edmond, Oklahoma |
| Authorized Official Name and Position | Adam Daniel (OWNER/OPERATOR) |
| Authorized Official Contact | 4052656142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenside Prairies Llc 3104 Nw 184th St Edmond OK 73012-9650 Ph: () - | Greenside Prairies Llc 3104 Nw 184th St Edmond OK 73012-9650 Ph: (405) 265-6142 |
| NPI Number | 1770466682 |
|---|---|
| Provider Enumeration Date | 07/28/2025 |
| Last Update Date | 07/28/2025 |
| Certification Date | 07/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770466682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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