MEDICARE: YWCA OKLAHOMA CITY

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	:	1811133143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YWCA OKLAHOMA CITY

Provider Business Mailing Address
First Line	:	2460 W I 44 SERVICE RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8703
Country	:	US
Telephone Number	:	405-948-1770
Fax Number	:	405-943-7177

Provider Business Practice Location Address
First Line	:	2460 W I 44 SERVICE RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8703
Country	:	US
Telephone Number	:	405-948-1770
Fax Number	:	405-943-7177

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. JANET L PEERY
Credential	:
Telephone Number	:	405-948-1770

Provider Enumeration Date	:	12/16/2008
Last Update Date	:	12/16/2008

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