Provider Demographics
NPI:1093879421
Name:WESTERN PLAINS YOUTH AND FAMILY SERVICES INC.
Entity Type:Organization
Organization Name:WESTERN PLAINS YOUTH AND FAMILY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-256-3157
Mailing Address - Street 1:1213 W HANKS TRL
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-7601
Mailing Address - Country:US
Mailing Address - Phone:580-256-3157
Mailing Address - Fax:580-256-1063
Practice Address - Street 1:1213 W HANKS TRL
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-7601
Practice Address - Country:US
Practice Address - Phone:580-254-5322
Practice Address - Fax:580-254-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100732920BMedicaid
OK100732920HMedicaid