Provider Demographics
NPI:1568630069
Name:ALLIED COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:ALLIED COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-769-3688
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:NICOMA PARK
Mailing Address - State:OK
Mailing Address - Zip Code:73066-0430
Mailing Address - Country:US
Mailing Address - Phone:405-769-3688
Mailing Address - Fax:405-769-0023
Practice Address - Street 1:2405 N WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:NICOMA PARK
Practice Address - State:OK
Practice Address - Zip Code:73066-0430
Practice Address - Country:US
Practice Address - Phone:405-769-3688
Practice Address - Fax:405-769-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services