| Millennium Community Services LLC | |
|
312 N Van Buren St Enid OK 73703-4500 | |
| (580) 297-5125 | |
| (580) 297-5126 |
| Full Name | Millennium Community Services LLC |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 312 N Van Buren St, Enid, Oklahoma |
| Authorized Official Name and Position | Wade L Hamil (CEO) |
| Authorized Official Contact | 4055739905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Community Services LLC 3816 Shadowridge Dr Norman OK 73072-5308 Ph: (888) 573-7792 | Millennium Community Services LLC 312 N Van Buren St Enid OK 73703-4500 Ph: (580) 297-5125 |
| NPI Number | 1013309616 |
|---|---|
| Provider Enumeration Date | 02/19/2015 |
| Last Update Date | 08/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013309616 | NPI | - | NPPES |
| 200129170F | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
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