| Faith Family Developmental Center | |
|
Rr 1 Box 131c Eufaula OK 74432-9223 | |
| (918) 452-3512 | |
| (918) 452-3512 |
| Full Name | Faith Family Developmental Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | Rr 1 Box 131c, Eufaula, Oklahoma |
| Authorized Official Name and Position | Randy Duane Randleman (PSYCHOLOGIST) |
| Authorized Official Contact | 9184523512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Family Developmental Center Rr 1 Box 131c Eufaula OK 74432-9223 Ph: (918) 452-3512 | Faith Family Developmental Center Rr 1 Box 131c Eufaula OK 74432-9223 Ph: (918) 452-3512 |
| NPI Number | 1215261219 |
|---|---|
| Provider Enumeration Date | 09/23/2009 |
| Last Update Date | 09/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215261219 | NPI | - | NPPES |
| 200097840-A | Medicaid | OK | |
| 100839240-A | Medicaid | OK | |
| 200097840-B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 825 (Oklahoma) | Primary |
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