| Eastern Oklahoma Youth Services, Inc. | |
|
511 College Ct Tahlequah OK 74464-4747 | |
| (918) 453-0600 | |
| (918) 453-0628 |
| Full Name | Eastern Oklahoma Youth Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 511 College Ct, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Kent Ryan Kelley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9184205325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Oklahoma Youth Services, Inc. 2626 S 14th St Suite A20 Mcalester OK 74501-7383 Ph: (918) 420-5325 | Eastern Oklahoma Youth Services, Inc. 511 College Ct Tahlequah OK 74464-4747 Ph: (918) 453-0600 |
| NPI Number | 1447594502 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447594502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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