Healthcare Provider Details

I. General information

NPI: 1689761827
Provider Name (Legal Business Name): THE BAIR FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 E 81ST ST STE 120
TULSA OK
74133-4158
US

IV. Provider business mailing address

241 HIGH ST
NEW WILMINGTON PA
16142-1116
US

V. Phone/Fax

Practice location:
  • Phone: 918-727-2555
  • Fax: 918-218-9662
Mailing address:
  • Phone: 724-946-8711
  • Fax: 724-946-3249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SUE RICKARD
Title or Position: ACCOUNTS RECEIVABLE SUPERVISOR
Credential:
Phone: 724-946-8711