| Jackie Horton Llc | |
|
Rr 4 Box 854 Coalgate OK 74538-9624 | |
| (580) 399-5398 | |
| (580) 927-2346 |
| Full Name | Jackie Horton Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | Rr 4 Box 854, Coalgate, Oklahoma |
| Authorized Official Name and Position | Jackie Horton (OWNER) |
| Authorized Official Contact | 5803995398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie Horton Llc Rr 4 Box 854 Coalgate OK 74538-9624 Ph: (580) 399-5398 | Jackie Horton Llc Rr 4 Box 854 Coalgate OK 74538-9624 Ph: (580) 399-5398 |
| NPI Number | 1154702256 |
|---|---|
| Provider Enumeration Date | 06/15/2015 |
| Last Update Date | 06/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154702256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5730 (Oklahoma) | Primary |
Pennington Creek Life House Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 S Michigan St Ste B, Coalgate, OK 74538 Phone: 580-310-4164 |