| Tri-city Youth & Family Center, Inc. | |
|
14625 Ne 23rd St Choctaw OK 73020-8728 | |
| (405) 390-8131 | |
| (405) 390-8134 |
| Full Name | Tri-city Youth & Family Center, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 14625 Ne 23rd St, Choctaw, Oklahoma |
| Authorized Official Name and Position | Donald J. Abbott (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4053908131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-city Youth & Family Center, Inc. Po Box 695 Choctaw OK 73020-0695 Ph: (405) 390-8131 | Tri-city Youth & Family Center, Inc. 14625 Ne 23rd St Choctaw OK 73020-8728 Ph: (405) 390-8131 |
| NPI Number | 1881775211 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881775211 | NPI | - | NPPES |
| 100732420A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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