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General NPI Number Information
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NPI Number | 1770336893
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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 | 04/09/2024
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 16111 STATE HIGHWAY 9 E
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City | EUFAULA
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State | OK
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Zip | 74432-5270
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Country | US
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Telephone | 539-269-4120
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Fax | 539-269-4022
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Provider Business Mailing Address
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Address Line | 4103 S YALE AVE STE B
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City | TULSA
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State | OK
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Zip | 74135-6002
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Country | US
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Telephone | 918-382-7300
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Fax | 918-392-3471
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Authorized Official
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Title or Position | CIO
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Name | JOSHUA WILLIAMS
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Credential |
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Telephone | 918-382-7300
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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 |
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License Number State |
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