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282 State Highway 10 Kansas OK 74347-1640 | |
(918) 708-9009 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 282 State Highway 10, Kansas, Oklahoma |
Authorized Official Name and Position | Jennifer Leigh Leep (DIRECTOR) |
Authorized Official Contact | 9183161468 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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16414 W 760 Rd Tahlequah OK 74464-1675 Ph: (918) 708-9009 | 282 State Highway 10 Kansas OK 74347-1640 Ph: (918) 708-9009 |
NPI Number | 1700641057 |
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Provider Enumeration Date | 02/15/2024 |
Last Update Date | 12/31/2024 |
Certification Date | 12/31/2024 |
Identifier | Type | State | Issuer |
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1700641057 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |