Provider Demographics
NPI:1720152614
Name:DIVERSIFIED FAMILY SERVICES INC
Entity Type:Organization
Organization Name:DIVERSIFIED FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:PARKHURST
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC LADC
Authorized Official - Phone:580-225-4337
Mailing Address - Street 1:PO BOX 2438
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648
Mailing Address - Country:US
Mailing Address - Phone:580-225-4337
Mailing Address - Fax:580-225-4338
Practice Address - Street 1:1021 E HWY 66
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644
Practice Address - Country:US
Practice Address - Phone:580-225-4337
Practice Address - Fax:580-225-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health