| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 112 Mickley N, Chandler, Oklahoma |
| Authorized Official Name and Position | Verna Foust (CEO) |
| Authorized Official Contact | 4054247711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
112 Mickley St N Chandler OK 74834 Ph: (405) 258-3070 | 112 Mickley N Chandler OK 74834 Ph: (405) 258-3040 |
| NPI Number | 1235359548 |
|---|---|
| Provider Enumeration Date | 04/27/2007 |
| Last Update Date | 09/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235359548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 080079897 (Oklahoma) | Primary |
Gateway To Prevention & Recovery Chandler Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 W 1st St, Chandler, OK 74834 Phone: 405-273-1170 Fax: 405-241-6447 | |