White Horse Ranch Outpatient, Llc | |
40803 S County Road 213 1601 Wilkie Road Mooreland OK 73852-9131 | |
(580) 994-5649 | |
(580) 994-5972 |
Full Name | White Horse Ranch Outpatient, Llc |
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Speciality | Counselor - Mental Health |
Location | 40803 S County Road 213, Mooreland, Oklahoma |
Authorized Official Name and Position | Tammie Renee Smith (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5805711272 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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White Horse Ranch Outpatient, Llc 40803 S County Road 213 1601 Wilkie Road Mooreland OK 73852-9131 Ph: (580) 994-5649 | White Horse Ranch Outpatient, Llc 40803 S County Road 213 1601 Wilkie Road Mooreland OK 73852-9131 Ph: (580) 994-5649 |
NPI Number | 1699158683 |
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Provider Enumeration Date | 07/08/2015 |
Last Update Date | 07/08/2015 |
Identifier | Type | State | Issuer |
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1699158683 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 4974 (Oklahoma) | Primary |
251S00000X | Community/behavioral Health | 839 (Oklahoma) | Secondary |