MEDICARE: HEALTH NETWORK, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1215183801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH NETWORK, LLC

Provider Business Mailing Address
First Line	:	3100 S ELM PLACE
Second Line	:	SUITE B
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012
Country	:	US
Telephone Number	:	918-286-2535
Fax Number	:	918-286-7693

Provider Business Practice Location Address
First Line	:	3100 S ELM PL
Second Line	:	SUITE B
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-7950
Country	:	US
Telephone Number	:	918-286-2535
Fax Number	:	918-286-7693

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL E CRAWFORD
Credential	:	MED
Telephone Number	:	918-286-2535

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	08/14/2008

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Directions to “HEALTH NETWORK, LLC ” Practice Location

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