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General NPI Number Information
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NPI Number | 1912291543
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION IN TULSA
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 3322 E 30TH ST
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City | TULSA
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State | OK
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Zip | 74114-6108
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Country | US
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Telephone | 918-382-2412
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Fax | 918-585-1263
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Provider Business Mailing Address
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Address Line | 3322 E 30TH ST
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City | TULSA
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State | OK
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Zip | 74114-6108
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Country | US
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Telephone | 918-382-2412
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Fax | 918-585-1263
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Authorized Official
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Title or Position | TEAM LEADER
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Name | MS. SUE HENSON
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Credential |
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Telephone | 918-955-6245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | OK
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