Provider Demographics
NPI:1114536224
Name:YOUTH SERVICES OF OSAGE COUNTY, INC.
Entity Type:Organization
Organization Name:YOUTH SERVICES OF OSAGE COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-766-5401
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056-0166
Mailing Address - Country:US
Mailing Address - Phone:918-287-2882
Mailing Address - Fax:918-287-2822
Practice Address - Street 1:1616 MCKENZIE
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056
Practice Address - Country:US
Practice Address - Phone:918-287-2881
Practice Address - Fax:918-287-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty