Provider Demographics
NPI:1790795789
Name:YCO CLINTON, INC.
Entity Type:Organization
Organization Name:YCO CLINTON, INC.
Other - Org Name:YOUTHCARE OF OKLAHOMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBATO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:866-926-6552
Mailing Address - Street 1:114 1/2 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-4740
Mailing Address - Country:US
Mailing Address - Phone:866-926-6552
Mailing Address - Fax:580-225-1130
Practice Address - Street 1:114 1/2 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4740
Practice Address - Country:US
Practice Address - Phone:866-926-6552
Practice Address - Fax:580-225-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management