Provider Demographics
NPI:1003366691
Name:OKLAHOMA FAMILIES FIRST, INC
Entity Type:Organization
Organization Name:OKLAHOMA FAMILIES FIRST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LBP
Authorized Official - Phone:405-360-2133
Mailing Address - Street 1:2600 VAN BUREN ST STE 2634
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5610
Mailing Address - Country:US
Mailing Address - Phone:405-360-2133
Mailing Address - Fax:405-360-4821
Practice Address - Street 1:2015 W BROADWAY ST STE 51A
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2501
Practice Address - Country:US
Practice Address - Phone:580-226-9388
Practice Address - Fax:580-226-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK860000112322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children