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NPI Code Detail

MEDICARE: YCO CLINTON INC

MEDICARE: YCO CLINTON INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency734OK
2251S00000XCommunity/Behavioral Health Agency3990OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235461641
Entity Type Code : Organization
Provider Name (Legal Business Name) : YCO CLINTON INC
Provider Business Mailing Address
First Line : 120 S MADISON AVE
Second Line :
City : ELK CITY
State : OK
Zip : 73644-5741
Country : US
Telephone Number : 158-066-0557
Fax Number :
Provider Business Practice Location Address
First Line : 120 S MADISON AVE
Second Line :
City : ELK CITY
State : OK
Zip : 73644-5741
Country : US
Telephone Number : 580-660-5573
Fax Number :
Authorized Official
Title or Position : CFO
Name : ROBERT LOBATO
Credential : MBA
Telephone Number : 18669266552
Provider Enumeration Date : 02/10/2010
Last Update Date : 02/10/2010

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Directions to “YCO CLINTON INC ” Practice Location

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