MEDICARE: YWCA TULSA 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
1	251S00000X	Community/Behavioral Health Agency	1549	OK
2	251S00000X	Community/Behavioral Health Agency	3545	OK
3	251S00000X	Community/Behavioral Health Agency	1177	OK

General Provider Information

NPI Number	:	1457501702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YWCA TULSA INC.

Provider Business Mailing Address
First Line	:	1910 S LEWIS AVE
Second Line	:	SUITE 200
City	:	TULSA
State	:	OK
Zip	:	74104-5723
Country	:	US
Telephone Number	:	918-587-2100
Fax Number	:	918-587-0277

Provider Business Practice Location Address
First Line	:	6450 S. LEWIS, SUITE 300
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136
Country	:	US
Telephone Number	:	918-587-2100
Fax Number	:	918-588-9394

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. JULIE RACHELLE DAVIS
Credential	:
Telephone Number	:	918-858-2346

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	04/22/2024

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Directions to “YWCA TULSA INC. ” Practice Location

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