| Organization Name: | CLAY CROSSING FOUNDATION |
| NPI Number: | 1114332442 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRET LEIKER (EXECUTIVE DIRECTOR) |
| Mailing Address: | 32018 Highway 59 Maud |
| State: | OK US |
| Postal Code: | 74854 |
| Phone Number: | 8663741220 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2014 |
| NPI Last Update Date: | 06/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 956 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |