Healthcare Provider Details
I. General information
NPI: 1457517872
Provider Name (Legal Business Name): PALMER CONTINUUM OF CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2008
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 S. SHERIDAN RD.
TULSA OK
74112
US
IV. Provider business mailing address
711 S. SHERIDAN RD.
TULSA OK
74112
US
V. Phone/Fax
- Phone: 918-832-7764
- Fax: 918-832-7765
- Phone: 918-832-7764
- Fax: 918-832-7765
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GREG
SNEED
Title or Position: EXCUTIVE DIRECTOR
Credential:
Phone: 918-832-7764