Provider Demographics
NPI:1104360692
Name:CREOKS MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CREOKS MENTAL HEALTH SERVICES
Other - Org Name:CREOKS BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:GOHEALTH HELPDESK MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-382-7300
Mailing Address - Street 1:203 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-6818
Mailing Address - Country:US
Mailing Address - Phone:918-542-6412
Mailing Address - Fax:918-542-6482
Practice Address - Street 1:203 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6818
Practice Address - Country:US
Practice Address - Phone:918-542-6412
Practice Address - Fax:918-542-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health