| Logan Community Services | |
|
4710 S Division St Guthrie OK 73044-6506 | |
| (405) 282-5524 | |
| Not Available |
| Full Name | Logan Community Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 4710 S Division St, Guthrie, Oklahoma |
| Authorized Official Name and Position | Nichole D Graves (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4052825524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Community Services Po Box 1558 Guthrie OK 73044-1558 Ph: (405) 282-5524 | Logan Community Services 4710 S Division St Guthrie OK 73044-6506 Ph: (405) 282-5524 |
| NPI Number | 1669590949 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669590949 | NPI | - | NPPES |
| 100733910A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Oklahoma) | Primary |
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