| Foundations Behavioral Health, LLC | |
|
16382 E Highway 20 Claremore OK 74019-3946 | |
| (918) 508-9696 | |
| Not Available |
| Full Name | Foundations Behavioral Health, LLC |
|---|---|
| Speciality | Counselor |
| Location | 16382 E Highway 20, Claremore, Oklahoma |
| Authorized Official Name and Position | Grace Ballard (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9185089696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Behavioral Health, LLC Po Box 3062 Claremore OK 74018-3062 Ph: (918) 508-9696 | Foundations Behavioral Health, LLC 16382 E Highway 20 Claremore OK 74019-3946 Ph: (918) 508-9696 |
| NPI Number | 1326429598 |
|---|---|
| Provider Enumeration Date | 06/14/2015 |
| Last Update Date | 06/14/2024 |
| Certification Date | 06/14/2024 |
| Medicare PECOS PAC ID | 4981950862 |
|---|---|
| Medicare Enrollment ID | O20180706001976 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326429598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Grace Ballard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902137631 PECOS PAC ID: 1759516156 Enrollment ID: I20131019000047 |
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