Provider Demographics
NPI:1225221195
Name:MUSKOGEE ASSOC. FOR THE RIGHTS OF CITIZENS W/DEVELOPMENTAL DISABLED
Entity Type:Organization
Organization Name:MUSKOGEE ASSOC. FOR THE RIGHTS OF CITIZENS W/DEVELOPMENTAL DISABLED
Other - Org Name:MUSKOGEE ASSOC. FOR THE RIGHTS OF RETARDED CITIZENS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-683-8162
Mailing Address - Street 1:PO BOX 546
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74402-0546
Mailing Address - Country:US
Mailing Address - Phone:918-683-8162
Mailing Address - Fax:918-687-5368
Practice Address - Street 1:210 E OKMULGEE ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-5453
Practice Address - Country:US
Practice Address - Phone:918-683-8162
Practice Address - Fax:918-687-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities