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General NPI Number Information
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NPI Number | 1811540362
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Entity Type | Organization
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Legal Business Name | PEORIA TRIBE OF INDIANS OF OKLAHOMA
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 118 S EIGHT TRIBES TRL
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City | MIAMI
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State | OK
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Zip | 74354-1002
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Country | US
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Telephone | 918-540-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 118 S EIGHT TRIBES TRL
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City | MIAMI
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State | OK
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Zip | 74354-1002
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Country | US
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Telephone | 918-540-2535
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Fax |
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Authorized Official
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Title or Position | PROGRAM DEVELOPMENT SPECIALIST
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Name | JORDAN BARLOW
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Credential |
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Telephone | 918-540-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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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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