| Organization Name: | CANADIAN COUNTY |
| NPI Number: | 1245450444 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOAN SOUTH (FACILITY DIRECTOR) |
| Mailing Address: | 7905 East Highway 66 El Reno |
| State: | OK US |
| Postal Code: | 73036 |
| Phone Number: | 4052620202 |
| Fax Number: | 4052620259 |
| NPI Enumeration Date: | 04/27/2007 |
| NPI Last Update Date: | 06/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | K850000246 |
| 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: | |