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General NPI Number Information
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NPI Number | 1154214039
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Entity Type | Organization
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Legal Business Name | SALTNETWORK
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1618 NW 32ND ST
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City | LAWTON
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State | OK
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Zip | 73505-3802
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Country | US
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Telephone | 404-716-2644
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Fax |
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Provider Business Mailing Address
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Address Line | 1618 NW 32ND ST
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City | LAWTON
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State | OK
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Zip | 73505-3802
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Country | US
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Telephone | 404-716-2644
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT E BURNS
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Credential |
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Telephone | 404-716-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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