Organization Name: | TENKILLER BEHAVIORAL SERVICES INC |
NPI Number: | 1134291859 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVETTA MCINTOSH (CEO OWNER) |
Mailing Address: | 27753 S Welling Rd Welling |
State: | OK US |
Postal Code: | 744712202 |
Phone Number: | 9184574999 |
Fax Number: | 9184574104 |
NPI Enumeration Date: | 11/15/2006 |
NPI Last Update Date: | 11/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |