Provider Demographics
NPI:1215291919
Name:PROMISES INCORPORATED
Entity type:Organization
Organization Name:PROMISES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:MHR, CADC
Authorized Official - Phone:405-270-0005
Mailing Address - Street 1:1900 NE 36TH ST
Mailing Address - Street 2:100 G
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-5218
Mailing Address - Country:US
Mailing Address - Phone:405-270-0005
Mailing Address - Fax:405-270-0956
Practice Address - Street 1:1900 NE 36TH ST
Practice Address - Street 2:100 G
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-5218
Practice Address - Country:US
Practice Address - Phone:405-270-0005
Practice Address - Fax:405-270-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK309101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty