Provider Demographics
NPI:1033493499
Name:AWARE
Entity Type:Organization
Organization Name:AWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:BS,CPRSS
Authorized Official - Phone:405-820-1533
Mailing Address - Street 1:35049 E 120-5
Mailing Address - Street 2:
Mailing Address - City:EARLSBORO
Mailing Address - State:OK
Mailing Address - Zip Code:74840-8600
Mailing Address - Country:US
Mailing Address - Phone:405-820-1533
Mailing Address - Fax:
Practice Address - Street 1:35049 E 120-5
Practice Address - Street 2:
Practice Address - City:EARLSBORO
Practice Address - State:OK
Practice Address - Zip Code:74840-8600
Practice Address - Country:US
Practice Address - Phone:405-820-1533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health