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General NPI Number Information
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NPI Number | 1679011290
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Entity Type | Organization
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Legal Business Name | MCALESTER REGIONAL HEALTH CENTER AUTHORITY
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1 E CLARK BASS BLVD
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City | MCALESTER
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State | OK
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Zip | 74501-4209
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Country | US
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Telephone | 918-421-8023
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Fax | 918-421-8631
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Provider Business Mailing Address
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Address Line | 1 E CLARK BASS BLVD
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City | MCALESTER
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State | OK
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Zip | 74501-4209
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Country | US
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Telephone | 918-421-8023
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Fax | 918-421-8631
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Authorized Official
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Title or Position | CEO
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Name | DAVID KEITH
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Credential |
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Telephone | 918-421-8101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 2203
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License Number State | OK
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