Provider Demographics
NPI:1932486909
Name:C4C
Entity Type:Organization
Organization Name:C4C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BHRS
Authorized Official - Prefix:MS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-413-2568
Mailing Address - Street 1:34396 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:OK
Mailing Address - Zip Code:74577-1019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34396 RIVER RD
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:OK
Practice Address - Zip Code:74577-1019
Practice Address - Country:US
Practice Address - Phone:918-413-2568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness