Full Name | |
---|---|
Speciality | Counselor - Professional |
Location | 509 West C Ave, Cache, Oklahoma |
Authorized Official Name and Position | Eric Paul Christian Rosenquist (LEAD COUNSELOR) |
Authorized Official Contact | 5804292700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 181 Cache OK 73527-0181 Ph: (580) 429-2700 | 509 West C Ave Cache OK 73527 Ph: (580) 429-2700 |
NPI Number | 1316225212 |
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Provider Enumeration Date | 07/26/2011 |
Last Update Date | 07/26/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316225212 | NPI | - | NPPES |
200334980A | Medicaid | OK |