Provider Demographics
NPI:1649460650
Name:PAYNE COUNTY DRUG COURT, INC.
Entity type:Organization
Organization Name:PAYNE COUNTY DRUG COURT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-743-1968
Mailing Address - Street 1:217 W 5TH AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4056
Mailing Address - Country:US
Mailing Address - Phone:405-743-1968
Mailing Address - Fax:405-743-1595
Practice Address - Street 1:217 W 5TH AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4056
Practice Address - Country:US
Practice Address - Phone:405-743-1968
Practice Address - Fax:405-743-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK462261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder