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General NPI Number Information
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NPI Number | 1437198843
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Entity Type | Organization
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Legal Business Name | UNITED COMMUNITY ACTION PROGRAM, INC.
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 DENVER ST
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City | PAWNEE
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State | OK
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Zip | 74058-3522
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Country | US
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Telephone | 918-762-3686
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Fax | 918-762-2617
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Provider Business Mailing Address
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Address Line | 501 6TH ST
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City | PAWNEE
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State | OK
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Zip | 74058-2542
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Country | US
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Telephone | 918-762-3686
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Fax | 918-762-2617
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. RONALD E. JESTES
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Credential | CADC
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Telephone | 918-762-3686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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