Provider Demographics
NPI:1457524639
Name:PARENT CHILD CENTER OF TULSA, INC.
Entity type:Organization
Organization Name:PARENT CHILD CENTER OF TULSA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - DATA MGMT & QUALITY ASSU
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-699-0525
Mailing Address - Street 1:1421 S BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-3607
Mailing Address - Country:US
Mailing Address - Phone:918-599-7999
Mailing Address - Fax:918-599-8054
Practice Address - Street 1:1421 S BOSTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-3607
Practice Address - Country:US
Practice Address - Phone:918-599-7999
Practice Address - Fax:918-599-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)