| Sequelcare Of Oklahoma, Llc | |
|
411 S Central Ave Idabel OK 74745-6059 | |
| (580) 286-5721 | |
| Not Available |
| Full Name | Sequelcare Of Oklahoma, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 411 S Central Ave, Idabel, Oklahoma |
| Authorized Official Name and Position | Dorothy Metcalf (EXEC DIR) |
| Authorized Official Contact | 5802982830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sequelcare Of Oklahoma, Llc Po Box 1030 Antlers OK 74523-1030 Ph: (580) 298-2830 | Sequelcare Of Oklahoma, Llc 411 S Central Ave Idabel OK 74745-6059 Ph: (580) 286-5721 |
| NPI Number | 1740344290 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 12/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740344290 | NPI | - | NPPES |
| 100744370N | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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