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General NPI Number Information
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NPI Number | 1487867263
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Entity Type | Organization
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Legal Business Name | CREOKS BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2455 N BOSTON PL
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City | TULSA
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State | OK
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Zip | 74106-3610
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Country | US
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Telephone | 918-583-8709
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Fax |
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Provider Business Mailing Address
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Address Line | 2455 N BOSTON PL
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City | TULSA
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State | OK
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Zip | 74106-3610
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Country | US
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Telephone | 918-583-8709
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MISS ISAAC MICHAEL HARRIS
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Credential | MS
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Telephone | 918-583-8709
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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 | 00000000
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License Number State | OK
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