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General NPI Number Information
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NPI Number | 1962225037
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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 | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 23 E ROSS AVE
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City | SAPULPA
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State | OK
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Zip | 74066-6423
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Country | US
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Telephone | 918-216-4999
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Fax |
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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 |
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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