| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 101 S Main St, Miami, Oklahoma |
| Authorized Official Name and Position | Shirlye Bass (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9185425543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
101 S Main St Miami OK 74354-7024 Ph: (918) 542-5543 | 101 S Main St Miami OK 74354-7024 Ph: (918) 542-5543 |
| NPI Number | 1942414974 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942414974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Oklahoma) | Primary |
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