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General NPI Number Information
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NPI Number | 1386939767
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 528 W BROADWAY AVE
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City | ENID
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State | OK
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Zip | 73701-3842
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Country | US
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Telephone | 580-237-2542
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Fax |
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Provider Business Mailing Address
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Address Line | 528 W BROADWAY AVE
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City | ENID
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State | OK
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Zip | 73701-3842
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Country | US
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Telephone | 580-237-7352
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Fax |
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Authorized Official
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Title or Position | PROGRAM COORDINATOR
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Name | MRS. STACY KURTZ
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Credential | LPC
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Telephone | 580-237-7352
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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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