| Cofmc Konawa | |
|
527 W 3rd St Konawa OK 74849 | |
| (580) 925-3286 | |
| (580) 925-2362 |
| Full Name | Cofmc Konawa |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 527 W 3rd St, Konawa, Oklahoma |
| Authorized Official Name and Position | Denise Sharp (INTERIM CE.O.) |
| Authorized Official Contact | 5809253286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cofmc Konawa Po Box 358 527 W 3rd St Konawa OK 74849 Ph: (580) 925-3286 | Cofmc Konawa 527 W 3rd St Konawa OK 74849 Ph: (580) 925-3286 |
| NPI Number | 1649485996 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649485996 | NPI | - | NPPES |
| 100737160D | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
The Anchor Therapy Program Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Rr 2 Box 79, Konawa, OK 74849 Phone: 580-925-2127 |