OrganizationPersonal Revolutions Behavioral Health Services, Llc(<Unavail>)CounselorBehavioral Health & Social Service ProvidersPractice Address6801 S Western Ave Ste 101, Oklahoma City, OK 73139-1816(405) 550-2688PECOS EnrollmentBased on the most recent information from CMS, provider Personal Revolutions Behavioral Health Services, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1164939765Provider TypeOrganizationFull NamePersonal Revolutions Behavioral Health Services, LlcOther Name<Unavail>SubpartNoEnumeration Date1/4/2018Last Updated2/24/2026Contact InformationPractice LocationPractice Address6801 S Western Ave Ste 101, Oklahoma City, OK 73139-1816Phone(405) 550-2688Fax(405) 619-3924Mailing LocationMailing Address6801 S Western Ave Ste 101, Oklahoma City, OK 73139-1816Phone(405) 550-2688Fax(405) 619-3924Authorized OfficialNameHaltom, Krystal Dawn (Owner)Phone(405) 550-2688Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense6323OklahomaProvider IdentifiersIDDescriptionIssuerID2003754400BDescriptionMedicaidIssuerUnlistedOklahoma