Provider Demographics
NPI:1518623735
Name:BENT CREEK BEHAVIORAL HEALTH SERVICES, PLLC
Entity Type:Organization
Organization Name:BENT CREEK BEHAVIORAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHERY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELTERBRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-922-5612
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:SEILING
Mailing Address - State:OK
Mailing Address - Zip Code:73663-0177
Mailing Address - Country:US
Mailing Address - Phone:580-922-5656
Mailing Address - Fax:580-922-3261
Practice Address - Street 1:1116 19TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2925
Practice Address - Country:US
Practice Address - Phone:580-922-5656
Practice Address - Fax:580-922-3261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)