| Yco Tulsa, Inc | |
|
1323 N 16th Ave Durant OK 74701-2134 | |
| (866) 926-6552 | |
| Not Available |
| Full Name | Yco Tulsa, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1323 N 16th Ave, Durant, Oklahoma |
| Authorized Official Name and Position | Robert Lobato (CEO) |
| Authorized Official Contact | 8669266552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Yco Tulsa, Inc Po Box 95207 Oklahoma City OK 73143-5207 Ph: (866) 926-6552 | Yco Tulsa, Inc 1323 N 16th Ave Durant OK 74701-2134 Ph: (866) 926-6552 |
| NPI Number | 1871502047 |
|---|---|
| Provider Enumeration Date | 08/06/2006 |
| Last Update Date | 10/21/2020 |
| Certification Date | 10/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871502047 | NPI | - | NPPES |
| 100744460D | Medicaid | OK |
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