MEDICARE: POSITIVE SOLUTIONS YOUTH & FAMILY SERVICES 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	251B00000X	Case Management Agency		OK
2	251S00000X	Community/Behavioral Health Agency		OK

General Provider Information

NPI Number	:	1780981530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE SOLUTIONS YOUTH & FAMILY SERVICES INC

Provider Business Mailing Address
First Line	:	5724 SE 86TH
Second Line	:
City	:	OKLAHOMA CITY
State	:	N/A
Zip	:	73135
Country	:	UM
Telephone Number	:	405-864-5724
Fax Number	:

Provider Business Practice Location Address
First Line	:	5724 SE 86TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73135-6025
Country	:	US
Telephone Number	:	405-863-5724
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. LARRENDA D PATTERSON
Credential	:	MS,LPC,LADC(CAND)
Telephone Number	:	405-863-5724

Provider Enumeration Date	:	02/14/2011
Last Update Date	:	03/21/2011

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