| Gateway To Prevention And Recovery Seminole | |
|
919 Jefferson St Seminole OK 74868-3150 | |
| (405) 273-1170 | |
| (405) 385-6604 |
| Full Name | Gateway To Prevention And Recovery Seminole |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 919 Jefferson St, Seminole, Oklahoma |
| Authorized Official Name and Position | Jon Greenwood (CEO) |
| Authorized Official Contact | 4052701170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway To Prevention And Recovery Seminole 36609 45th St Shawnee OK 74804-8882 Ph: (405) 273-1170 | Gateway To Prevention And Recovery Seminole 919 Jefferson St Seminole OK 74868-3150 Ph: (405) 273-1170 |
| NPI Number | 1457897373 |
|---|---|
| Provider Enumeration Date | 01/17/2017 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457897373 | NPI | - | NPPES |
| 100736990 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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