Provider Demographics
NPI:1376845578
Name:CAPES CLINIC, LLC
Entity Type:Organization
Organization Name:CAPES CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:RINEER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-747-8282
Mailing Address - Street 1:3311 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2903
Mailing Address - Country:US
Mailing Address - Phone:918-747-8282
Mailing Address - Fax:918-747-6601
Practice Address - Street 1:5350 E 46TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6612
Practice Address - Country:US
Practice Address - Phone:918-747-8282
Practice Address - Fax:918-747-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty