Provider Demographics
NPI:1639438674
Name:NORTH OKLAHOMA COUNTY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:NORTH OKLAHOMA COUNTY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:NORTHCARE
Authorized Official - Middle Name:
Authorized Official - Last Name:CREDENTIALING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-858-2700
Mailing Address - Street 1:2403 S DIVISION ST STE C&D
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 S ACADEMY RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-8727
Practice Address - Country:US
Practice Address - Phone:405-858-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2023-04-28
Deactivation Date:2023-03-31
Deactivation Code:
Reactivation Date:2023-04-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health