Provider Demographics
NPI:1114019262
Name:SOUTH CENTRAL INDUSTRIES, INC
Entity Type:Organization
Organization Name:SOUTH CENTRAL INDUSTRIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLICK
Authorized Official - Suffix:
Authorized Official - Credentials:AS
Authorized Official - Phone:405-275-3851
Mailing Address - Street 1:PO BOX 3766
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74802-3766
Mailing Address - Country:US
Mailing Address - Phone:405-275-3851
Mailing Address - Fax:405-275-7001
Practice Address - Street 1:130 N LOUISA AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6828
Practice Address - Country:US
Practice Address - Phone:405-275-3851
Practice Address - Fax:405-275-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services