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NPI 1568380749

NPI 1568380749 : CREOKS MENTAL HEALTH SERVICES, INC : IDABEL, OK

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General NPI Number Information
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    NPI Number           |    1568380749
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    Entity Type          |    Organization 
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    Legal Business Name  |    CREOKS MENTAL HEALTH SERVICES, INC 
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Dates
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    Enumeration Date     |    07/07/2026
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    Last Update Date     |    07/07/2026
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Provider Practice Location Address
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    Address Line         |    2000 E LINCOLN RD 
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    City                 |    IDABEL
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    State                |    OK
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    Zip                  |    74745-7353
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    Country              |    US
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    Telephone            |    580-286-6639
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 700360 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74170-0360
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    Country              |    US
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    Telephone            |    918-382-7300
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CREDENTIALING DIRECTOR
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    Name                 |     KERRI  WATSON 
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    Credential           |    
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    Telephone            |    918-698-1771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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