| Providence Service Corporation Of Oklahoma | |
|
116 Se Ave N Idabel OK 74745-5234 | |
| (580) 924-6363 | |
| Not Available |
| Full Name | Providence Service Corporation Of Oklahoma |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 116 Se Ave N, Idabel, Oklahoma |
| Authorized Official Name and Position | Lynnette Richey (STATE DIRECTOR) |
| Authorized Official Contact | 5809246363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Service Corporation Of Oklahoma 630 N Craycroft Rd Suite 250 Tucson AZ 85711-1440 Ph: (520) 747-6600 | Providence Service Corporation Of Oklahoma 116 Se Ave N Idabel OK 74745-5234 Ph: (580) 924-6363 |
| NPI Number | 1295154581 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 04/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295154581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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