Provider Demographics
NPI:1063659845
Name:OLTESI BEHAVIORAL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:OLTESI BEHAVIORAL HEALTH SERVICES, INC
Other - Org Name:OLTESI EMS SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLINS
Authorized Official - Middle Name:EMEKA
Authorized Official - Last Name:O'KEHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-572-0811
Mailing Address - Street 1:301 S 9TH ST
Mailing Address - Street 2:STE 208
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3448
Mailing Address - Country:US
Mailing Address - Phone:713-572-0811
Mailing Address - Fax:281-271-8151
Practice Address - Street 1:301 S 9TH ST
Practice Address - Street 2:STE 208
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3448
Practice Address - Country:US
Practice Address - Phone:713-572-0811
Practice Address - Fax:281-271-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10002163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200819501Medicaid
TXAMB1034OtherBLUE CROSS AND BLUE SHIELD
TX200819501Medicaid