| Northeastern Health System | |
|
1323 W Keetoowah St Tahlequah OK 74464-3462 | |
| (918) 506-6901 | |
| Not Available |
| Full Name | Northeastern Health System |
|---|---|
| Speciality | Counselor |
| Location | 1323 W Keetoowah St, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Jackie Hullinger (VP OF REVENUE CYCLE) |
| Authorized Official Contact | 9184582417 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeastern Health System Po Box 1008 Tahlequah OK 74465-1008 Ph: (918) 458-2111 | Northeastern Health System 1323 W Keetoowah St Tahlequah OK 74464-3462 Ph: (918) 506-6901 |
| NPI Number | 1689338519 |
|---|---|
| Provider Enumeration Date | 10/27/2021 |
| Last Update Date | 11/07/2024 |
| Certification Date | 11/07/2024 |
| Medicare PECOS PAC ID | 1456255025 |
|---|---|
| Medicare Enrollment ID | O20231016000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689338519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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