Provider Demographics
NPI:1235573676
Name:PAYNE COUNTY DRUG COURT, INC.
Entity Type:Organization
Organization Name:PAYNE COUNTY DRUG COURT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-743-1968
Mailing Address - Street 1:608 W HIGHPOINT DR
Mailing Address - Street 2:P.O. BOX 817
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1530
Mailing Address - Country:US
Mailing Address - Phone:405-743-1968
Mailing Address - Fax:405-743-1595
Practice Address - Street 1:608 W HIGHPOINT DR
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-1530
Practice Address - Country:US
Practice Address - Phone:405-743-1968
Practice Address - Fax:405-743-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)