| NPI | 1669987830 |
|---|---|
| Former Legal Business Name | LA VIDA FEARLESS COUNSELING |
| Entity Type | Organization |
| Authorized Contact | DANNY PODOBNIK Manager 405-810-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OK 6158) |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2019-06-11 |