Healthcare Provider Details

I. General information

NPI: 1952151649
Provider Name (Legal Business Name): JUNCTION REFUGE COUNSELING & DUI SCHOOL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E MAIN ST UNIT D
STIGLER OK
74462-2704
US

IV. Provider business mailing address

11378 W HIGHWAY 9
STIGLER OK
74462-3609
US

V. Phone/Fax

Practice location:
  • Phone: 918-442-9847
  • Fax:
Mailing address:
  • Phone: 918-442-9847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN L PECK
Title or Position: OWNER
Credential: LPC
Phone: 918-442-9847