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General NPI Number Information
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NPI Number | 1922440171
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Entity Type | Organization
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Legal Business Name | TULSA CENTER FOR BEHAVIOUR HEALTH
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 2323 S HARVARD AVE
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City | TULSA
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State | OK
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Zip | 74114-3301
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Country | US
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Telephone | 918-378-0359
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Fax |
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Provider Business Mailing Address
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Address Line | 10426 E 42ND ST LOT 217
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City | TULSA
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State | OK
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Zip | 74146-3744
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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 | CRS
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Name | JESSICA RILEY
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Credential |
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Telephone | 918-378-0359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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