Kickapoo Behavioral Health

NPI 1063607117 - Clinic/Center - 261QR0405X

NPI Details
NPI 1063607117
Enumeration Date 09/12/2007
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name WILLA DEAN WILLA
Position SUBSTANCE ABUSE COUNSELOR
Phone (405) 964-2081
Fax (405) 964-5677
Practice Location
404 NORTH HIGHWAY 102
MCLOUD OK, 74851, US
Phone (405) 964-2081
Fax (405) 964-5677
Business Location
407 NORTH HIGHWAY 102
MCLOUD OK, 74851, US
Phone (405) 964-2081
Fax (405) 964-5677
Toxanomy
Taxonomy Code 261QR0405X
License State Oklahoma
License Number 98
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According to our database, Kickapoo Behavioral Health NPI is 1063607117, taxonomy code is 261QR0405X and license number is 98, license state is located at Oklahoma. Kickapoo Behavioral Health physically located at 404 North Highway 102, Mcloud OK, 74851. NPI Number 1033115704 has the healthcare provider type.

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1063607117 NPI number is provided on an as is basis without warranty of any kind. 1063607117 is maintained by the National Plan & Provider Enumeration System. The contents of Kickapoo Behavioral Health are for informational purposes only.