| Port Lawrence Behavioral Health Services Llc | |
|
7901 Ne 10th St Midwest City OK 73110-3600 | |
| (405) 326-7721 | |
| Not Available |
| Full Name | Port Lawrence Behavioral Health Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7901 Ne 10th St, Midwest City, Oklahoma |
| Authorized Official Name and Position | Frank C. Calvin (PRESIDENT) |
| Authorized Official Contact | 4053267721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Lawrence Behavioral Health Services Llc 8617 Honey Locust Dr Spencer OK 73084-2115 Ph: (405) 326-7721 | Port Lawrence Behavioral Health Services Llc 7901 Ne 10th St Midwest City OK 73110-3600 Ph: (405) 326-7721 |
| NPI Number | 1891293759 |
|---|---|
| Provider Enumeration Date | 01/25/2018 |
| Last Update Date | 01/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891293759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Oklahoma) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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