Provider Demographics
NPI:1992834964
Name:PURVELL INC
Entity Type:Organization
Organization Name:PURVELL INC
Other - Org Name:FOCUS BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:P
Authorized Official - Last Name:BOROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LADC, CPS
Authorized Official - Phone:918-775-2657
Mailing Address - Street 1:1515 W CHICKASAW AVE
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-7201
Mailing Address - Country:US
Mailing Address - Phone:918-775-2657
Mailing Address - Fax:
Practice Address - Street 1:1515 W CHICKASAW AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-7201
Practice Address - Country:US
Practice Address - Phone:918-775-2657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK464101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty