Provider Demographics
NPI: | 1558015800 |
---|---|
Name: | STIGLER HEALTH AND WELLNESS CENTER INC |
Entity Type: | Organization |
Organization Name: | STIGLER HEALTH AND WELLNESS CENTER INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERESA |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | HUGGINS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 918-967-3368 |
Mailing Address - Street 1: | PO BOX 179 |
Mailing Address - Street 2: | |
Mailing Address - City: | STIGLER |
Mailing Address - State: | OK |
Mailing Address - Zip Code: | 74462-0179 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 918-967-3368 |
Mailing Address - Fax: | 918-967-4582 |
Practice Address - Street 1: | 1120 TARBY RD |
Practice Address - Street 2: | |
Practice Address - City: | POTEAU |
Practice Address - State: | OK |
Practice Address - Zip Code: | 74953-5504 |
Practice Address - Country: | US |
Practice Address - Phone: | 918-647-2155 |
Practice Address - Fax: | 918-647-4095 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | STIGLER HEALTH AND WELLNESS CENTER INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2022-02-07 |
Last Update Date: | 2022-02-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |