Provider Demographics
NPI:1093027609
Name:THE EXCHANGE CLUB CENTER FOR THE PREVENTION OF CHILD ABUSE OF OKLAHOMA
Entity Type:Organization
Organization Name:THE EXCHANGE CLUB CENTER FOR THE PREVENTION OF CHILD ABUSE OF OKLAHOMA
Other - Org Name:PREVENT CHILD ABUSE OKLAHOMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:STIRLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-232-2500
Mailing Address - Street 1:437 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-3706
Mailing Address - Country:US
Mailing Address - Phone:405-232-2500
Mailing Address - Fax:405-232-0050
Practice Address - Street 1:437 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-3706
Practice Address - Country:US
Practice Address - Phone:405-232-2500
Practice Address - Fax:405-232-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4300594429251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable