Provider Demographics
NPI:1902196421
Name:INTEGRIS MENTAL HEALTH
Entity Type:Organization
Organization Name:INTEGRIS MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-427-2441
Mailing Address - Street 1:1304 GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-4710
Mailing Address - Country:US
Mailing Address - Phone:405-234-7047
Mailing Address - Fax:
Practice Address - Street 1:2601 SPENCER RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-3649
Practice Address - Country:US
Practice Address - Phone:405-427-2441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness