Provider Demographics
NPI:1891102331
Name:PANHANDLE COUNSELING & HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:PANHANDLE COUNSELING & HEALTH CENTER, INC.
Other - Org Name:PANHANDLE PATHWAYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-338-7270
Mailing Address - Street 1:5170 PATRICIA BLVD
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-0000
Mailing Address - Country:US
Mailing Address - Phone:580-338-3553
Mailing Address - Fax:
Practice Address - Street 1:5170 PATRICIA BLVD
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-0000
Practice Address - Country:US
Practice Address - Phone:580-338-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PANHANDLE COUNSELING & HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-16
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty