Pavilion Behavioral Health Llc | |
99855 Highway 82 Vian OK 74962-6073 | |
(479) 353-2368 | |
Not Available |
Full Name | Pavilion Behavioral Health Llc |
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Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
Location | 99855 Highway 82, Vian, Oklahoma |
Authorized Official Name and Position | Dzaidi Daud (CEO/PRESIDENT) |
Authorized Official Contact | 4793532368 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pavilion Behavioral Health Llc 99855 Highway 82 Vian OK 74962-6073 Ph: (479) 353-2368 | Pavilion Behavioral Health Llc 99855 Highway 82 Vian OK 74962-6073 Ph: (479) 353-2368 |
NPI Number | 1992539472 |
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Provider Enumeration Date | 08/28/2024 |
Last Update Date | 08/28/2024 |
Certification Date | 08/28/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992539472 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |