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General NPI Number Information
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NPI Number | 1245549567
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Entity Type | Organization
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Legal Business Name | PS&A CASE MANAGEMENT & PROVIDER AGENCY
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 4528 S SHERIDAN RD STE 113
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City | TULSA
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State | OK
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Zip | 74145-1101
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Country | US
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Telephone | 918-282-5363
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Fax | 918-585-7152
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Provider Business Mailing Address
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Address Line | 4528 S SHERIDAN RD STE 113
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City | TULSA
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State | OK
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Zip | 74145-1140
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Country | US
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Telephone | 918-282-5363
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Fax | 918-585-7152
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Authorized Official
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Title or Position | CEO / EXECUTIVE DIRECTOR
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Name | PATRICE D. SIMPKINS
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Credential | MHR / MRC
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Telephone | 918-282-5363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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