| State Of Oklahoma | |
|
702 N. Grand Northwest Center For Behavioral Health Enid OK 73701 | |
| (580) 234-3791 | |
| (580) 237-7711 |
| Full Name | State Of Oklahoma |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 702 N. Grand, Enid, Oklahoma |
| Authorized Official Name and Position | Trudy Hoffman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5805713233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Oklahoma 1222 10th Street, Suite 211 Northwest Center For Behavioral Health Woodward OK 73801-3156 Ph: (580) 571-3217 | State Of Oklahoma 702 N. Grand Northwest Center For Behavioral Health Enid OK 73701 Ph: (580) 234-3791 |
| NPI Number | 1720152788 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 02/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720152788 | NPI | - | NPPES |
| 100646280D | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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