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General NPI Number Information
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NPI Number | 1548328396
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Entity Type | Organization
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Legal Business Name | EXCEPTIONAL CHILDREN SERVICE
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 WEST BROADWAY SUITE 010
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City | MUSKOGEE
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State | OK
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Zip | 74403
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Country | US
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Telephone | 918-687-1090
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Fax | 918-684-1602
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Provider Business Mailing Address
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Address Line | 400 WEST BROADWAY SUITE 010
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City | MUSKOGEE
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State | OK
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Zip | 74403
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Country | US
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Telephone | 918-687-1090
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Fax | 918-684-1602
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CHARLOTTE M HOOD
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Credential | SCHOOL BASED
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Telephone | 918-687-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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