Provider Demographics
NPI:1922078815
Name:GLEN OAKS HOSPITAL, INC.
Entity Type:Organization
Organization Name:GLEN OAKS HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO SR VP
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:301 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-4101
Mailing Address - Country:US
Mailing Address - Phone:903-454-6000
Mailing Address - Fax:
Practice Address - Street 1:301 DIVISION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-4101
Practice Address - Country:US
Practice Address - Phone:903-454-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00754283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112746602Medicaid
AR157880105Medicaid
AR157880105Medicaid
TX454050Medicare Oscar/Certification
AR157880105Medicaid
TN=========001OtherCHAMPUS