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General NPI Number Information
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NPI Number | 1457558298
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Entity Type | Organization
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Legal Business Name | FAMILY CRISIS CENTER, INC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 605 E 12TH ST
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City | ADA
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State | OK
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Zip | 74820-6605
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Country | US
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Telephone | 580-436-3504
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Fax | 580-436-5047
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Provider Business Mailing Address
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Address Line | PO BOX 2274
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City | ADA
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State | OK
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Zip | 74821-2274
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Country | US
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Telephone | 580-436-3504
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Fax | 580-436-5047
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DENNIS K. AULD
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Credential | CADC
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Telephone | 580-436-3504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OK
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