| Eagle Ridge Institute | |
|
109 S Harrill Ave Wagoner OK 74467-5317 | |
| (918) 485-3554 | |
| (918) 485-8371 |
| Full Name | Eagle Ridge Institute |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 109 S Harrill Ave, Wagoner, Oklahoma |
| Authorized Official Name and Position | William Clark (AREA PROGRAM DIRECTOR) |
| Authorized Official Contact | 9184853554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Ridge Institute 109 S Harrill Ave Wagoner OK 74467-5317 Ph: (918) 485-3554 | Eagle Ridge Institute 109 S Harrill Ave Wagoner OK 74467-5317 Ph: (918) 485-3554 |
| NPI Number | 1629285267 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629285267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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