Healthcare Provider Details

I. General information

NPI: 1881916062
Provider Name (Legal Business Name): BRIGGS FAMILY & YOUTH ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 02/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 N SHARTEL AVE SUITE 600
OKLAHOMA CITY OK
73103-2400
US

IV. Provider business mailing address

706 N RAILROAD ST
HINTON OK
73047-9007
US

V. Phone/Fax

Practice location:
  • Phone: 405-521-8652
  • Fax:
Mailing address:
  • Phone: 405-545-0913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number4034
License Number StateOK

VIII. Authorized Official

Name: MS. JANICE BRIGGS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 405-521-8635