| Sisu Youth, Inc. | |
|
2129 Nw 30th St Oklahoma City OK 73112-7901 | |
| (405) 459-7478 | |
| Not Available |
| Full Name | Sisu Youth, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2129 Nw 30th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Meagan Kaye Mathis (CLINICAL SERVICES MANAGER) |
| Authorized Official Contact | 4055895709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sisu Youth, Inc. 3131 N Pennsylvania Ave Oklahoma City OK 73112-7931 Ph: (405) 589-5709 | Sisu Youth, Inc. 2129 Nw 30th St Oklahoma City OK 73112-7901 Ph: (405) 459-7478 |
| NPI Number | 1174385900 |
|---|---|
| Provider Enumeration Date | 01/26/2024 |
| Last Update Date | 01/26/2024 |
| Certification Date | 01/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174385900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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