Provider Demographics
NPI:1376955161
Name:REFUGE TREATMENT SERVICES
Entity Type:Organization
Organization Name:REFUGE TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:RATZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-272-8012
Mailing Address - Street 1:101 W. BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MANNSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:73447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 W. BROADWAY
Practice Address - Street 2:
Practice Address - City:MANNSVILLE
Practice Address - State:OK
Practice Address - Zip Code:73447
Practice Address - Country:US
Practice Address - Phone:580-272-8012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health