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NPI Code Detail

MEDICARE: WILLOW CREST HOSPITAL, INC

MEDICARE: WILLOW CREST HOSPITAL, INC
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
1323P00000XPsychiatric Residential Treatment Facility2555OK

General Provider Information

NPI Number : 1417014853
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLOW CREST HOSPITAL, INC
Provider Business Mailing Address
First Line : 130 A ST SW
Second Line :
City : MIAMI
State : OK
Zip : 74354-6806
Country : US
Telephone Number : 918-541-1215
Fax Number :
Provider Business Practice Location Address
First Line : 130 A ST SW
Second Line :
City : MIAMI
State : OK
Zip : 74354-6806
Country : US
Telephone Number : 918-541-1215
Fax Number :
Authorized Official
Title or Position : ASSISTANT ADMINISTRATOR OPERATIONS
Name : SHARI MURPHREE
Credential :
Telephone Number : 918-541-1215
Provider Enumeration Date : 01/03/2007
Last Update Date : 08/22/2020

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Directions to “WILLOW CREST HOSPITAL, INC ” Practice Location

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