Provider Demographics
NPI:1487867263
Name:CREOKS BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CREOKS BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:918-583-8709
Mailing Address - Street 1:2455 N BOSTON PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-3610
Mailing Address - Country:US
Mailing Address - Phone:918-583-8709
Mailing Address - Fax:
Practice Address - Street 1:2455 N BOSTON PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-3610
Practice Address - Country:US
Practice Address - Phone:918-583-8709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK00000000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health