Provider Demographics
NPI:1588672208
Name:CREEK NATION HEALTH SYSTEMS
Entity Type:Organization
Organization Name:CREEK NATION HEALTH SYSTEMS
Other - Org Name:CREEK NATION BEHAVIORAL HEALTH/SUBSTABCE ABUSE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:SECRETARY OF HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-756-3334
Mailing Address - Street 1:DEPT 1467
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74182-0001
Mailing Address - Country:US
Mailing Address - Phone:918-756-4333
Mailing Address - Fax:
Practice Address - Street 1:100 W 7TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-5007
Practice Address - Country:US
Practice Address - Phone:918-758-1910
Practice Address - Fax:918-756-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center