State Of Oklahoma | |
1222 10th Street, Suite 211 Northwest Center For Behavioral Health Woodward OK 73801-3156 | |
(580) 571-3217 | |
(580) 256-8609 |
Full Name | State Of Oklahoma |
---|---|
Speciality | Clinic/center - Medical Specialty |
Location | 1222 10th Street, Suite 211, Woodward, Oklahoma |
Authorized Official Name and Position | Autumn Nickelson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5805713231 |
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 1222 10th Street, Suite 211 Northwest Center For Behavioral Health Woodward OK 73801-3156 Ph: (580) 571-3217 |
NPI Number | 1750456588 |
---|---|
Provider Enumeration Date | 11/20/2006 |
Last Update Date | 03/24/2022 |
Certification Date | 03/24/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750456588 | NPI | - | NPPES |
100707390A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Primary |
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› Verified 8 days ago
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