Provider Demographics
NPI:1518333087
Name:PEACEFUL FAMILY SOLUTIONS INC
Entity Type:Organization
Organization Name:PEACEFUL FAMILY SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:KATIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LADC/MH
Authorized Official - Phone:405-601-2691
Mailing Address - Street 1:7405 S. DOUGLAS AVENUE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139
Mailing Address - Country:US
Mailing Address - Phone:405-601-2691
Mailing Address - Fax:405-601-2773
Practice Address - Street 1:7405 S DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1911
Practice Address - Country:US
Practice Address - Phone:405-601-2691
Practice Address - Fax:405-601-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK922101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200524760BMedicaid