Provider Demographics
NPI:1497973101
Name:FIRST CHOICE INTEGRATED COUNSELING
Entity Type:Organization
Organization Name:FIRST CHOICE INTEGRATED COUNSELING
Other - Org Name:TOX INTEGRATED GUIDANCE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PROFESSIONA
Authorized Official - Phone:405-634-6055
Mailing Address - Street 1:5714 S. WESTERN AVE.
Mailing Address - Street 2:SUITE D
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109
Mailing Address - Country:US
Mailing Address - Phone:405-634-6055
Mailing Address - Fax:405-634-6061
Practice Address - Street 1:5714 S. WESTERN AVE.
Practice Address - Street 2:SUITE D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109
Practice Address - Country:US
Practice Address - Phone:405-634-6055
Practice Address - Fax:405-634-6061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200021660AMedicaid