Healthcare Provider Details

I. General information

NPI: 1063630192
Provider Name (Legal Business Name): CARL ALBERT COMMUNITY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 EAST MONROE
MCALESTER OK
74501
US

IV. Provider business mailing address

1101 E. MONROE
MCALESTER OK
74501
US

V. Phone/Fax

Practice location:
  • Phone: 918-426-7800
  • Fax: 918-426-5526
Mailing address:
  • Phone: 918-426-7800
  • Fax: 918-426-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR 0073312
License Number StateOK

VIII. Authorized Official

Name: MRS. DORIS FRIEDA BARLOW
Title or Position: REGISTERED NURSE
Credential: RN
Phone: 918-426-7800