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General NPI Number Information
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NPI Number | 1881488229
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Entity Type | Organization
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Legal Business Name | PAWNEE NATION MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1204 HERITAGE CIRCLE
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City | PAWNEE
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State | OK
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Zip | 74058-0470
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Country | US
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Telephone | 918-212-0344
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Fax | 918-212-4351
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Provider Business Mailing Address
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Address Line | PO BOX 470
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City | PAWNEE
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State | OK
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Zip | 74058-0470
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Country | US
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Telephone | 918-212-0344
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Fax | 918-212-4351
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Authorized Official
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Title or Position | INTERIM CHIEF OPERATING OFFICER
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Name | BRIAN E KIRK
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Credential |
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Telephone | 918-212-0344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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