| Eagle Ridge Institute | |
|
1515 W Chickasaw Sallisaw OK 74955 | |
| (918) 775-4646 | |
| (405) 282-3038 |
| Full Name | Eagle Ridge Institute |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1515 W Chickasaw, Sallisaw, Oklahoma |
| Authorized Official Name and Position | Tammy M Vaughn (ASSOCIATE EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4052825283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Ridge Institute 601 Ne 63 St Oklahoma City OK 73105 Ph: (405) 282-5283 | Eagle Ridge Institute 1515 W Chickasaw Sallisaw OK 74955 Ph: (918) 775-4646 |
| NPI Number | 1669602173 |
|---|---|
| Provider Enumeration Date | 07/17/2009 |
| Last Update Date | 07/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669602173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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