MEDICARE: THOMAS YOUTH & FAMILY SERVICE

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

General Provider Information

NPI Number	:	1487098331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS YOUTH & FAMILY SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 13362
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73113-1362
Country	:	US
Telephone Number	:	405-822-3452
Fax Number	:

Provider Business Practice Location Address
First Line	:	2237 NW 117TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-7804
Country	:	US
Telephone Number	:	405-822-3452
Fax Number	:

Authorized Official
Title or Position	:	BHRS
Name	:	GERREL THOMAS
Credential	:
Telephone Number	:	405-822-3452

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	04/23/2013

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Directions to “THOMAS YOUTH & FAMILY SERVICE ” Practice Location

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