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General NPI Number Information
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NPI Number | 1154485225
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Entity Type | Organization
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Legal Business Name | BRIGHTER HEIGHTS OKLAHOMA, LLC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 401 N CHURCH ST
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City | POTEAU
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State | OK
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Zip | 74953-3502
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Country | US
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Telephone | 918-649-0230
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Fax | 918-649-1492
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Provider Business Mailing Address
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Address Line | PO BOX 1030
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City | ANTLERS
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State | OK
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Zip | 74523-1030
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Country | US
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Telephone | 580-298-2830
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Fax | 580-298-6723
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Authorized Official
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Title or Position | EXEC DIR
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Name | DOROTHY MCKINNON
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Credential | MSW, LCSW, LADC
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Telephone | 580-298-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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