Provider Demographics
NPI:1528603198
Name:CREOKS MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CREOKS MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GOHEALTH HELPDESK MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-382-7300
Mailing Address - Street 1:4103 S YALE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6002
Mailing Address - Country:US
Mailing Address - Phone:918-382-7300
Mailing Address - Fax:
Practice Address - Street 1:186 W COURT ST
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-1822
Practice Address - Country:US
Practice Address - Phone:580-364-0669
Practice Address - Fax:580-364-0673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)