Healthcare Provider Details

I. General information

NPI: 1679771745
Provider Name (Legal Business Name): ASSOCIATED CENTERS FOR THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 S YALE AVE STE 215
TULSA OK
74136-5743
US

IV. Provider business mailing address

7010 S YALE AVE STE 215
TULSA OK
74136-5743
US

V. Phone/Fax

Practice location:
  • Phone: 918-492-2554
  • Fax: 918-494-9870
Mailing address:
  • Phone: 918-492-2554
  • Fax: 918-494-9870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAMMY HORNE
Title or Position: CONTROLLER
Credential:
Phone: 918-492-2554