| Yco Tulsa, Inc. | |
|
2100 North Louis Tittle Suites 122-124 And 147-148 Mangum OK 73554 | |
| (580) 309-7961 | |
| Not Available |
| Full Name | Yco Tulsa, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2100 North Louis Tittle, Mangum, Oklahoma |
| Authorized Official Name and Position | Robert Lobato (CEO) |
| Authorized Official Contact | 8669266552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Yco Tulsa, Inc. Po Box 95207 Oklahoma City OK 73143-5207 Ph: (866) 926-6552 | Yco Tulsa, Inc. 2100 North Louis Tittle Suites 122-124 And 147-148 Mangum OK 73554 Ph: (580) 309-7961 |
| NPI Number | 1740640648 |
|---|---|
| Provider Enumeration Date | 03/04/2016 |
| Last Update Date | 10/22/2020 |
| Certification Date | 10/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740640648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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