Provider Demographics
NPI:1417393836
Name:LILYFIELD, INC.
Entity Type:Organization
Organization Name:LILYFIELD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-216-5240
Mailing Address - Street 1:501 E 15TH ST
Mailing Address - Street 2:STE. 400A
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5043
Mailing Address - Country:US
Mailing Address - Phone:405-216-5240
Mailing Address - Fax:405-285-0294
Practice Address - Street 1:501 E 15TH ST
Practice Address - Street 2:STE. 400A
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5043
Practice Address - Country:US
Practice Address - Phone:405-216-5240
Practice Address - Fax:405-285-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
OKK860000182253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251S00000XAgenciesCommunity/Behavioral Health