National Provider Identifier Database

BRENDA SUE MATHIS
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.


Contact Information

BRENDA SUE MATHIS
4034 W ROANOKE PL
BROKEN ARROW, OK74011-1327
Phone: 918-698-7171
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X
Psychiatric Residential Treatment Facility 323P00000X
Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for BRENDA SUE MATHIS

NPI Number 1215261086
Legal business name
LBN
BRENDA SUE MATHIS
Authorized official BRENDA MATHIS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/28/2009
Last updated 09/28/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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