| Red Rock Behavioral Health Services Inc. | |
|
1336 N Harrison Ave Shawnee OK 74801-5206 | |
| (405) 424-7711 | |
| Not Available |
| Full Name | Red Rock Behavioral Health Services Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1336 N Harrison Ave, Shawnee, Oklahoma |
| Authorized Official Name and Position | Angi Maxwell-duverger (MANAGER CREDENTIALING AND PROVIDER) |
| Authorized Official Contact | 4054247711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Rock Behavioral Health Services Inc. 4400 N Lincoln Blvd Oklahoma City OK 73105-5104 Ph: (405) 424-7711 | Red Rock Behavioral Health Services Inc. 1336 N Harrison Ave Shawnee OK 74801-5206 Ph: (405) 424-7711 |
| NPI Number | 1649755158 |
|---|---|
| Provider Enumeration Date | 10/01/2018 |
| Last Update Date | 11/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649755158 | NPI | - | NPPES |
| 100635250 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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