| Providence Of Oklahoma | |
|
301 N High St Antlers OK 74523-2238 | |
| (580) 298-5779 | |
| (580) 298-5016 |
| Full Name | Providence Of Oklahoma |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 301 N High St, Antlers, Oklahoma |
| Authorized Official Name and Position | Breeann Marie Hoerning (AR AND BILLING MANAGER) |
| Authorized Official Contact | 5207476600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Of Oklahoma 620 N Craycroft Rd Tucson AZ 85711-1448 Ph: (520) 747-6600 | Providence Of Oklahoma 301 N High St Antlers OK 74523-2238 Ph: (580) 298-5779 |
| NPI Number | 1639239023 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639239023 | NPI | - | NPPES |
| 100750190M | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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