| Bigheart, Llc | |
|
254 County Road 2351 Barnsdall OK 74002-5174 | |
| (918) 914-1327 | |
| Not Available |
| Full Name | Bigheart, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 254 County Road 2351, Barnsdall, Oklahoma |
| Authorized Official Name and Position | Ealisa Caitlyn Adams (OWNER) |
| Authorized Official Contact | 9189141327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bigheart, Llc Po Box 808 Barnsdall OK 74002-0808 Ph: (918) 914-1327 | Bigheart, Llc 254 County Road 2351 Barnsdall OK 74002-5174 Ph: (918) 914-1327 |
| NPI Number | 1750995320 |
|---|---|
| Provider Enumeration Date | 09/01/2020 |
| Last Update Date | 09/10/2020 |
| Certification Date | 09/10/2020 |
| Medicare PECOS PAC ID | 9638589591 |
|---|---|
| Medicare Enrollment ID | O20201103003113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750995320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ealisa Caitlyn Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043557671 PECOS PAC ID: 8729324355 Enrollment ID: I20201103003122 |
Grand Lake Medical Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 W Main St, Barnsdall, OK 74002 Phone: 918-337-8080 Fax: 918-337-8099 | |
Grand Lake Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 W Main St, Barnsdall, OK 74002 Phone: 918-847-3527 Fax: 918-777-9018 |