Provider Demographics
NPI:1912282112
Name:FAMILY OPTIONS COMMUNITY BASED SERVICES
Entity Type:Organization
Organization Name:FAMILY OPTIONS COMMUNITY BASED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-604-9790
Mailing Address - Street 1:2914 EPPERLY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-3322
Mailing Address - Country:US
Mailing Address - Phone:405-604-9790
Mailing Address - Fax:405-702-7668
Practice Address - Street 1:2914 EPPERLY DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3322
Practice Address - Country:US
Practice Address - Phone:405-604-9790
Practice Address - Fax:405-702-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKTEMP251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health