Healthcare Provider Details

I. General information

NPI: 1780981530
Provider Name (Legal Business Name): POSITIVE SOLUTIONS YOUTH & FAMILY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5724 SE 86TH ST
OKLAHOMA CITY OK
73135-6025
US

IV. Provider business mailing address

5724 SE 86TH
OKLAHOMA CITY N/A
73135
UM

V. Phone/Fax

Practice location:
  • Phone: 405-863-5724
  • Fax:
Mailing address:
  • Phone: 405-864-5724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOK

VIII. Authorized Official

Name: MS. LARRENDA D PATTERSON
Title or Position: EXECUTIVE DIRECTOR
Credential: MS,LPC,LADC(CAND)
Phone: 405-863-5724