| Cimarron Valley Therapeutic Services, Inc. | |
|
205 W Hartford Ave Ponca City OK 74601-1547 | |
| (580) 765-0076 | |
| (580) 765-0073 |
| Full Name | Cimarron Valley Therapeutic Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 205 W Hartford Ave, Ponca City, Oklahoma |
| Authorized Official Name and Position | Steve Gates (PROGRAM DIRECTOR) |
| Authorized Official Contact | 5802542886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cimarron Valley Therapeutic Services, Inc. 205 W Hartford Ave Ponca City OK 74601-1547 Ph: (580) 765-0076 | Cimarron Valley Therapeutic Services, Inc. 205 W Hartford Ave Ponca City OK 74601-1547 Ph: (580) 765-0076 |
| NPI Number | 1851415673 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851415673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | K8600113 (Oklahoma) | Primary |
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