Healthcare Provider Details

I. General information

NPI: 1881522126
Provider Name (Legal Business Name): CHILDRENS BEHAVIORAL CENTERS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 S CENTRAL AVE
IDABEL OK
74745-4625
US

IV. Provider business mailing address

17 S CENTRAL AVE
IDABEL OK
74745-4625
US

V. Phone/Fax

Practice location:
  • Phone: 580-353-9726
  • Fax: 580-271-6790
Mailing address:
  • Phone: 580-353-9726
  • Fax: 580-271-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CORBIN GABREAL PATE
Title or Position: PARTNER
Credential:
Phone: 580-317-3613