Provider Demographics
NPI:1518436518
Name:TOTAL CARE BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:TOTAL CARE BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:405-471-3601
Mailing Address - Street 1:5350 S WESTERN AVE STE 548
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-4536
Mailing Address - Country:US
Mailing Address - Phone:405-471-3601
Mailing Address - Fax:888-875-1829
Practice Address - Street 1:5350 S WESTERN AVE STE 548
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4536
Practice Address - Country:US
Practice Address - Phone:405-471-3601
Practice Address - Fax:888-875-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)