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General NPI Number Information
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NPI Number | 1760696355
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Entity Type | Organization
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Legal Business Name | NORTH CARE CENTER
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4436 NW 50TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2212
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Country | US
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Telephone | 405-858-2700
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Fax | 405-858-2880
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Provider Business Mailing Address
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Address Line | 1001 NW 21ST ST APT B
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-6210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHILD AND ADOLESCENT THERAPIST
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Name | MS. JILL R CLINE
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Credential |
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Telephone | 405-858-2861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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