| Phoenix Gate, Inc. | |
|
32 E Cherokee Ave Suite 104 Mcalester OK 74501-5323 | |
| (918) 423-9400 | |
| (918) 423-9400 |
| Full Name | Phoenix Gate, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 32 E Cherokee Ave, Mcalester, Oklahoma |
| Authorized Official Name and Position | Ivora P. Sensibaugh (SOCIAL WORKER) |
| Authorized Official Contact | 9184239400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Gate, Inc. 32 E Cherokee Ave Suite 104 Mcalester OK 74501-5323 Ph: (918) 423-9400 | Phoenix Gate, Inc. 32 E Cherokee Ave Suite 104 Mcalester OK 74501-5323 Ph: (918) 423-9400 |
| NPI Number | 1962733758 |
|---|---|
| Provider Enumeration Date | 01/19/2010 |
| Last Update Date | 01/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962733758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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