Provider Demographics
NPI:1023496080
Name:CHOCTAW NATION HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:CHOCTAW NATION HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:918-302-0052
Mailing Address - Street 1:604 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5814
Mailing Address - Country:US
Mailing Address - Phone:918-302-0052
Mailing Address - Fax:918-302-0082
Practice Address - Street 1:604 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5814
Practice Address - Country:US
Practice Address - Phone:918-302-0052
Practice Address - Fax:918-302-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal