Provider Demographics
NPI:1467525105
Name:AGENCY FOR YOUTH AND FAMILY DEVELOPMENT
Entity Type:Organization
Organization Name:AGENCY FOR YOUTH AND FAMILY DEVELOPMENT
Other - Org Name:ARAGON ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VPO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-701-1522
Mailing Address - Street 1:3400 DESKIN DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8295
Mailing Address - Country:US
Mailing Address - Phone:405-701-1522
Mailing Address - Fax:405-701-8531
Practice Address - Street 1:3400 DESKIN DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8295
Practice Address - Country:US
Practice Address - Phone:405-701-1522
Practice Address - Fax:405-701-8531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility