Healthcare Provider Details

I. General information

NPI: 1427151521
Provider Name (Legal Business Name): OKLAHOMA COUNTY CRISIS INTERVENTION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 GENERAL PERSHING
OKLAHOMA CITY OK
73107-3277
US

IV. Provider business mailing address

2000 N CLASSEN BLVD
OKLAHOMA CITY OK
73106-6016
US

V. Phone/Fax

Practice location:
  • Phone: 405-942-2300
  • Fax: 405-942-2303
Mailing address:
  • Phone: 405-248-9089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. LAUREN STOVER
Title or Position: EXECUTIVE DIRECTOR
Credential: LADC/MH
Phone: 405-795-6893