| Creoks Behavioral Health Services, Inc | |
|
109 S Harrill Ave Wagoner OK 74467-5317 | |
| (918) 485-0242 | |
| (918) 485-0204 |
| Full Name | Creoks Behavioral Health Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 109 S Harrill Ave, Wagoner, Oklahoma |
| Authorized Official Name and Position | Brent M. Black (CEO) |
| Authorized Official Contact | 9187569411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creoks Behavioral Health Services, Inc 4103 S Yale Ave Ste B Tulsa OK 74135-6002 Ph: (918) 382-7300 | Creoks Behavioral Health Services, Inc 109 S Harrill Ave Wagoner OK 74467-5317 Ph: (918) 485-0242 |
| NPI Number | 1407157456 |
|---|---|
| Provider Enumeration Date | 11/08/2010 |
| Last Update Date | 10/15/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407157456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 100734620 (Oklahoma) | Primary |
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