| Kiamichi Youth Service, Inc. | |
|
4 Se A Ave Idabel OK 74745-4620 | |
| (580) 286-6671 | |
| Not Available |
| Full Name | Kiamichi Youth Service, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4 Se A Ave, Idabel, Oklahoma |
| Authorized Official Name and Position | Deborah D. Lawson (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 5802866671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiamichi Youth Service, Inc. 4 Se A Ave Idabel OK 74745-4620 Ph: (580) 286-6671 | Kiamichi Youth Service, Inc. 4 Se A Ave Idabel OK 74745-4620 Ph: (580) 286-6671 |
| NPI Number | 1669597647 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669597647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 261QM0801X (Oklahoma) | Primary |
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