Provider Demographics
NPI:1477150530
Name:RED ROCK BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:RED ROCK BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH ASSOCIATE
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-525-3959
Mailing Address - Street 1:4400 N LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-5104
Mailing Address - Country:US
Mailing Address - Phone:405-525-3959
Mailing Address - Fax:
Practice Address - Street 1:2619 N HARVEY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-3017
Practice Address - Country:US
Practice Address - Phone:405-525-3959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging